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S. Bydder



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    P1.14 - Poster Session 1 - Mesothelioma (ID 194)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Mesothelioma
    • Presentations: 1
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      P1.14-006 - Catheter Tract Metastases Associated With Indwelling Pleural Catheters For Malignant Effusions (ID 2342)

      09:30 - 16:30  |  Author(s): S. Bydder

      • Abstract

      Background
      Indwelling pleural catheter (IPC) is commonly used in managing malignant pleural effusion (MPE). Tumor spread along the catheter tract remains a clinical concern for which limited data exist. We report the largest series of catheter tract metastases (CTM).

      Methods
      All patients who had IPC inserted for MPE in our Pleural Service were entered prospectively into a database. A retrospective review of the cases for CTM over a 50-month period from Jan 2009 was conducted. CTM was defined as a new chest wall swelling over the IPC insertion site or the tunneled subcutaneous tract. Patient demographics and risk factors were recorded. Multivariate regression analysis was performed.

      Results
      108 patients (77% male; 60% had mesothelioma) underwent a total of 111 IPC insertions. CTM occurred in 11 (10.2%) patients; 7 were males and 9 had mesothelioma. CTM developed after a median of 280 days (range 56-692 days) post-IPC insertion. 7 patients were symptomatic with chest wall pain and 6 received palliative radiotherapy for CTM. Radiotherapy was tolerated well with no major complications. CTM occurred more commonly, OR 3.30 (0.68-16.06), in mesothelioma patients than those with metastatic pleural cancers. Patients who had CTM had a significantly longer survival (median 369 days) than those who did not, HR 0.24 (CI 0.08-0.68).

      Conclusion
      Clinicians and patients should be aware that CTM could complicate IPC, especially in mesothelioma patients. The longer the patient survived after IPC placement, the higher risk of developing CTM. Symptoms associated with CTM were generally mild and responded well to palliative radiotherapy.