Predictors of survival in non‐small cell lung cancer patients with pleural effusion undergoing thoracoscopy

BACKGROUND: Malignant pleural effusion (MPE) predicts advanced disease and poor prognosis, and is usually diagnosed by medical thoracoscopy. It remains unclear whether the various representations visualized on thoracoscopy are reliable prognostic factors. The aim of this study was to evaluate prognostic factors for survival in patients who underwent thoracoscopy for MPE. METHODS: The medical records of consecutive patients with MPE who underwent medical thoracoscopy from 2007 to 2015 at a tertiary hospital were reviewed and theKaplan‐Meier method and Cox regression analysis used to determine prognostic factors. RESULTS: A total of 125 patients with non‐small cell lung cancer (NSCLC) were confirmed on tissue biopsy as having pleural metastasis. In NSCLC, factors adversely affecting overall survival (OS) in univariate analysis included extent of pleural carcinomatosis (EPC) score (P = 0.031), grade of adhesions (P = 0.037), costoparietal pleural lesions (P = 0.035) and bloody MPE (P = 0.023); Cox multivariate analysis revealed that EPC score (P = 0.007) and grade of adhesions (P = 0.019) were independent predictors of OS. CONCLUSIONS: Under traditional chemotherapy, higher EPC score and higher grades of adhesions predicted poor prognosis in advanced NSCLC patients with pleural metastasis. Taking into account these factors may allow doctors to make more accurate predictions and provide individual therapy when treating patients with MPE.