Journal of palliative medicine
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Malignant pleural effusions (MPEs) complicate many advanced malignancies and the median prognosis for those who develop MPEs is 6 months. These effusions lead patients to suffer from significant dyspnea, which may consequently impair mobility and lead to reduced quality of life. There are several treatment options for those with MPE. Thoracentesis may be quick and relatively easy to perform, but has a high recurrence rate; chest tube placement with talc slurry is quite effective at achieving pleurodesis, but this procedure can be quite painful and requires hospitalization. An alternative option is outpatient placement of the Pleurx catheter (Denver Biomedical Inc., Denver, CO) for home-based drainage of effusions. ⋯ The treatment choice (talc pleurodesis or Pleurx catheter) for those with an MPE and a prognosis of 6 months should be based on the clinical situation and patient preferences, as well as local expertise and success rates of the procedures. A prospective study specific to the palliative care population might help to clarify which treatment is more cost effective in this population in which optimizing quality of life is essential.