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.
