{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:26:07Z","timestamp":1787739967741,"version":"build-2784847793"},"reference-count":24,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T00:00:00Z","timestamp":1637884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Malignant pleural effusion (MPE) occurs in 15% of all cancer patients and usually portends poor prognosis while also serving to limit the patient\u2019s quality of life. Palliation of symptoms has been the goal for the management of these effusions while keeping the patient\u2019s hospital stay to a minimum. Traditionally, this has been achieved by chest tube drainage followed by the instillation of sclerosing agents, such as talc, in the pleural space. A recent increase in evidence for the effectiveness and convenience of indwelling pleural catheters has changed the management of MPE, which is reflected in the guidelines released by the American Thoracic Society as well their European Counterpart (ERS\/BTS). In this article, we aim to review the current management practices and guidelines for MPE.<\/jats:p>","DOI":"10.3390\/jcm10235535","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T01:43:22Z","timestamp":1638323002000},"page":"5535","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Malignant Pleural Effusions\u2014A Review of Current Guidelines and Practices"],"prefix":"10.3390","volume":"10","author":[{"given":"Prarthna Chandar","family":"Kulandaisamy","sequence":"first","affiliation":[{"name":"Department of Pulmonary, Allergy and Critical Care, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakthidev","family":"Kulandaisamy","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Allergy and Critical Care, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Allergy and Critical Care, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Mcgrath","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Allergy and Critical Care, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1164\/rccm.201807-1415ST","article-title":"Management of malignant pleural effusions. An official ATS\/STS\/STR clinical practice guideline","volume":"198","author":"Reddy","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1093\/ejcts\/ezy258","article-title":"ERS\/EACTS statement on the management of malignant pleural effusions","volume":"55","author":"Bibby","year":"2019","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"229","DOI":"10.2147\/CMAR.S95663","article-title":"Management of malignant pleural effusion: Challenges and solutions","volume":"9","author":"Penz","year":"2017","journal-title":"Cancer Manag. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/0002-9343(83)91072-0","article-title":"Mechanism of relief of dyspnea after thoracocentesis in patients with large pleural effusions","volume":"74","author":"Estenne","year":"1983","journal-title":"Am. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1097\/00063198-200007000-00003","article-title":"Management of malignant pleural mesothelioma: A critical review","volume":"6","author":"Lee","year":"2000","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1097\/MCP.0000000000000174","article-title":"Physiology of breathlessness associated with pleural effusions","volume":"21","author":"Thomas","year":"2015","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1136\/thx.2008.100545","article-title":"Thoracic ultrasound in the diagnosis of malignant pleural effusion","volume":"64","author":"Qureshi","year":"2009","journal-title":"Thorax"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S1111","DOI":"10.21037\/jtd.2017.07.79","article-title":"Diagnosis and management of malignant pleural effusions: State of the art in 2017","volume":"9","author":"Desai","year":"2017","journal-title":"J. Thorac. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1053\/crad.2000.0573","article-title":"Thoracic computed tomography in patients with suspected malignant pleural effusions","volume":"56","author":"Traill","year":"2001","journal-title":"Clin. Radiol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Arnold, D.T., De Fonseka, D., Perry, S., Morley, A., Harvey, J.E., Medford, A., Brett, M., and Maskell, N.A. (2018). Investigating unilateral pleural effusions: The role of cytology. Eur. Respir. J., 52.","DOI":"10.1183\/13993003.congress-2018.PA2868"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1378\/chest.09-0884","article-title":"Medical thoracoscopy vs. CT scan-guided Abrams pleural needle biopsy for diagnosis of patients with pleural effusions","volume":"137","author":"Metintas","year":"2010","journal-title":"Chest"},{"key":"ref_12","first-page":"1211","article-title":"Diagnostic approach to pleural effusion in adults","volume":"73","author":"Porcel","year":"2006","journal-title":"Am. Fam. Physician"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.arbres.2012.05.007","article-title":"Unexpandable lung","volume":"49","author":"Pereyra","year":"2013","journal-title":"Arch. Bronconeumol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1136\/thoraxjnl-2014-205285","article-title":"Predicting survival in malignant pleural effusion: Development and validation of the LENT prognostic score","volume":"69","author":"Clive","year":"2014","journal-title":"Thorax"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"i61","DOI":"10.1136\/thx.2010.137026","article-title":"Pleural procedures and thoracic ultrasound: British Thoracic Society pleural disease guideline 2010","volume":"65","author":"Havelock","year":"2010","journal-title":"Thorax"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.1378\/chest.124.6.2229","article-title":"Pleurodesis practice for malignant pleural effusions in five English-speaking countries","volume":"124","author":"Lee","year":"2003","journal-title":"Chest"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1001\/jama.2019.19997","article-title":"Effect of Thoracoscopic Talc Poudrage vs. Talc Slurry via Chest Tube on Pleurodesis Failure Rate among Patients with Malignant Pleural Effusions: A Randomized Clinical Trial","volume":"323","author":"Bhatnagar","year":"2020","journal-title":"JAMA"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1016\/S0140-6736(07)60708-9","article-title":"Safety of pleurodesis with talc poudrage in malignant pleural effusion: A prospective cohort study","volume":"369","author":"Janssen","year":"2007","journal-title":"Lancet"},{"key":"ref_19","first-page":"S339","article-title":"Thoracoscopy: Medical versus surgical\u2014In the management of pleural diseases","volume":"7","author":"Shojaee","year":"2015","journal-title":"J. Thorac. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1183\/09031936.00164706","article-title":"Use of tunnelled catheters for malignant pleural effusions in patients fit for pleurodesis","volume":"30","author":"Tremblay","year":"2007","journal-title":"Eur. Respir. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1001\/jama.2017.17426","article-title":"Effect of an Indwelling Pleural Catheter vs. Talc Pleurodesis on Hospitalization Days in Patients with Malignant Pleural Effusion: The AMPLE Randomized Clinical Trial","volume":"318","author":"Thomas","year":"2017","journal-title":"JAMA"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.1001\/jama.2012.5535","article-title":"Effect of an Indwelling Pleural Catheter vs. Chest Tube and Talc Pleurodesis for Relieving Dyspnea in Patients with Malignant Pleural Effusion: The TIME2 Randomized Controlled Trial","volume":"307","author":"Davies","year":"2012","journal-title":"JAMA"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S1010-7940(00)00422-X","article-title":"The long-term morbidity of pleuroperitoneal shunts in the management of recurrent malignant effusions","volume":"18","author":"Genc","year":"2000","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s13063-015-0563-y","article-title":"The efficacy of indwelling pleural catheter placement versus placement plus talc sclerosant in patients with malignant pleural effusions managed exclusively as outpatients (IPC-PLUS): Study protocol for a randomised controlled trial","volume":"16","author":"Bhatnagar","year":"2015","journal-title":"Trials"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/23\/5535\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:36:12Z","timestamp":1760168172000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/23\/5535"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,26]]},"references-count":24,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["jcm10235535"],"URL":"https:\/\/doi.org\/10.3390\/jcm10235535","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,26]]}}}