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Pleural Effusion in Mesothelioma Patients May Affect Survival

Published: June 18, 2021

Pleural effusion may affect mesothelioma survival. Pleural effusion is a buildup of fluid around the lungs that can be caused by multiple illnesses including heart failure, kidney and liver disease, pleural mesothelioma, and other cancers. The only way to treat this condition is to drain the fluid, which makes it easier for patients to breathe. Researchers found that in their own particular study, pleural effusion does not affect survival, but they believe that future research could prove that it actually does.

Pleural mesothelioma is a very aggressive cancer on the pleura, the lining of the lungs. In a healthy person, there is fluid between the layers, creating lubrication that allows the lungs to move in the chest. When someone has mesothelioma though, the body can produce too much fluid when trying to fight the tumors. Fluid then builds up between the layers, making lung expansion tougher. When people have mesothelioma, one of the first signs is difficulty breathing from pleural fluid buildup. Doctors either drain the fluid to improve comfort or perform pleurodesis, where the doctors close off the space chemically or physically.

Pleural mesothelioma is a deadly and dangerous cancer and a pleural effusion is an uncomfortable symptom, but not a danger to a person’s overall health. Researchers wanted to see if it was dangerous by looking at 761 patients from three hospitals in the United Kingdom. All the patients were diagnosed between 2008 and 2018. The patients’ medical images were examined to see the severity of the patients’ effusions and the length of time each patient had an effusion. The researchers also looked at other factors that could impact survival. They compared the length of time that a person had pleural fluid buildup and how long the person survived.

The median survival for the patients was 278 days and people who had pleurodesis lived longer with a survival of 473 days. The researchers could not find proof that the absence of pleural fluid caused this extra survival. The researchers concluded that pleural fluid exposure duration had no impact on survival. They do mention though that it’s unclear if duration of malignant pleural mesothelioma exposure to pleural fluid is associated with survival. Prospective studies need to be performed to see if pleural effusion exposure is dangerous. This was a retrospective study, which analyzes past data. If researchers want to find out if pleural effusion exposure is dangerous, they need to perform a prospective study, which is a study that looks for outcomes.


Rachel Asciak MD et al, “The association between pleural fluid exposure and survival in pleural mesothelioma” CHEST Journal (June 10, 2021). [Link]

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