Predicting survival in patients with recurrent symptomatic malignant pleural effusions - An assessment of the prognostic values of physiologic, morphologic, and quality of life measures of extent of disease
Predicting survival in patients with recurrent symptomatic malignant pleural effusions - An assessment of the prognostic values of physiologic, morphologic, and quality of life measures of extent of disease
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DOI：
10.1378/chest.117.1.73
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发表时间：
2000-01-01
期刊：
影响因子：
9.6
通讯作者：
Colt, HG
中科院分区：
文献类型：
--
作者：
Burrows, CM;Mathews, C;Colt, HG
普罗斯：为了确定胸水pH值、胸水葡萄糖、胸膜癌病程度（EPC）评分和Karnofsky体能量表（KPS）评分在复发性症状性恶性胸腔积液患者中的预后价值，设计：前瞻性53个月研究。85名连续患者（42名男性和43名女性）患有复发性症状性恶性胸腔积液，并被转诊至介入性肺服务进行胸腔镜胸膜固定术。胸水pH值、胸水葡萄糖、EPC评分和KPS评分。结果：KPS评分是唯一具有统计学意义的预测变量。KPS评分大于或等于70的患者的中位生存期为395天，而KPS评分小于或等于30的患者的中位生存期仅为34天。当患者被分类为胸水pH、胸水葡萄糖或EPC评分时，没有明显的预后优势。当评估复发性症状性恶性胸腔积液患者的预后时，只有胸腔镜检查时的KPS评分才能预测预后。胸腔液pH值、胸腔液葡萄糖和EPC评分不像最初报告的那样可靠。对于KPS评分大于或等于70的患者，进行胸腔镜滑石粉胸膜固定术治疗恶性胸腔积液可能是非常合理的。
Purose: To determine the prognostic value of pleural fluid pH, pleural fluid glucose, extent of pleural carcinomatosis (EPC) score, and Karnofsky Performance Scale (KPS) score in patients with recurrent symptomatic malignant pleural effusions,Design: Prospective 53-month study.Setting: Referral center for interventional pulmonology.Patients: Eighty-five consecutive patients (42 men and 43 women) with recurrent symptomatic malignant pleural effusions who were referred to the interventional pulmonary service for thoracoscopic pleurodesis.Measurements: Pleural fluid pH, pleural fluid glucose, EPC score, and KPS score.Results: The KPS score was the only statistically significant predictor variable. Patients with a KPS score greater than or equal to 70 had a median survival of 395 days, as opposed to a median survival of only 34 days for patients with a KPS score less than or equal to 30, No prognostic advantage was evident when patients were categorized bq pleural fluid pH, pleural fluid glucose, or EPC score.Conclusion: When assessing the prognosis of a patient with a recurrent symptomatic malignant pleural effusion, only the KPS score at the time of thoracoscopy is predictive of sunival. Pleural fluid pH, pleural fluid glucose, and EPC scores are not as reliable as initially reported, For patients with a KPS score greater than or equal to 70, it may be very reasonable to proceed with thoracoscopic talc pleurodesis for management of their malignant pleural effusions.