Outcomes of Patients with Gynecologic Malignancies Undergoing Video-Assisted Thoracoscopic Surgery (VATS) and Pleurodesis for Malignant Pleural Effusion

Outcomes of Patients with Gynecologic Malignancies Undergoing Video-Assisted Thoracoscopic Surgery (VATS) and Pleurodesis for Malignant Pleural Effusion

Background
We evaluated the indications and outcomes of patients with known gynecologic malignancies that underwent video-assisted thoracoscopic surgery (VATS) and pleurodesis for malignant pleural effusion.

Methods
After IRB approval was obtained, a retrospective study of patients with gynecologic malignancies who underwent planned VATS/pleurodesis between 1/2000 and 7/2010 was performed. Abstracted data included demographics, diagnosis, disease status, treatment history, indication for VATS, complications, and outcomes

Results
42 patients (University of Alabama) with a gynecologic malignancy underwent VATS/pleurodesis. Median age was 63 years. 29 patients (69%) had ovarian cancer. 57% had recurrent disease at the time of VATS and 57% were undergoing chemotherapy at the time of VATS. 8 patients (19%) underwent perioperative VATS to improve pulmonary status. 7 patients (17%) underwent a palliative VATS. The median length of stay was 7 days (range 1–53). 62% had gross disease noted at the time of VATS. A mean of 1650 cc of fluid was drained at time of surgery (range 300–4500), and the majority (88%) of patients had a talc pleurodesis performed. 7 patients (17%) were readmitted within 30 days; 6 were for complications unrelated to their VATS............. Patients who underwent a perioperative VATS had the longest survival (845 days).

Conclusion

Patients with gynecologic malignancies may require a VATS/pleurodesis for symptomatic pleural effusions. This procedure appears to be safe and effective in this patient population.

Highlights

► Many patients with gynecologic malignancies will develop pleural effusion
► Few studies exclusively evaluate the role of VATS/pleurodesis in gynecologic oncology patients
► VATS/pleurodesis can safely and effectively ameliorate symptoms of recurrent malignant pleural effusion.