Does Response to Talc Predict Mesothelioma Outlook?

Physicians in Italy state that a new study suggests that mesothelioma patients’ prognosis can be predicted better after going through a talc treatment. It may also predict more accurately than going by the subtype of the cancer or how advanced the stage of cancer is.

According to research performed at the University of Eastern Piedmont in Novara, Italy, 172 mesothelioma patients who underwent a treatment known as “talc pleurodesis” treatment, which reduces excessive lung fluid, showed a better indication of survival longevity after a follow-up. Per Dr. Ottavio Rena, a thoraic surgeon who worked on the study,  says talc tends to be a good indicator of a patient’s prognosis.

“Persistent lung expansion after pleural talc poudrage and absence of fluid recurrence is demonstrated to be a stronger factor in predicting survival than clinical stage and other clinical variables.”

Once the excessive fluid in the lungs are drained, the space in between the lungs is filled with talc. This procedure helps to close the pleural cavity so that more excessive fluid-up doesn’t return. Once the procedure was complete, 142 of the patients in the study experienced full lung expansion. At their 3-month check-up, 85 patients still had full lung expansion. In turn, Dr. Rena states that the talc treatment can better indicate the mesothelioma patient’s survival rate.

Other factors can also indicate survival rate. For example, the study suggests that the type of mesothelioma cancer the patient has indicates survival rate. Patients with non-epithelioid mesothelioma tend to have the lowest survival rates. In addition, the level of health and stage of the disease also factor into the prognosis, as well as how high the patient’s platelet count is. However, according the study, it’s the talc treatment, which promotes lung expansion, that is the biggest indicator of the prognosis.

Who Qualifies for Pleurodesis Treatment?

It’s important to note that not all mesothelioma patients will qualify for pleurodesis treatment. For instance, if a patient’s lung linings show severe tumor coverage, the treatment is less effective when sealing up the spaces between the lungs. Furthermore, patients with a prognosis of a few months or less generally do not qualify as the discomfort associated with it (inflammation).

Mesothelioma patients in stages I-III generally qualify, and in some instance, stage IV patients may qualify as well. Late-stage patients who are in extreme pain from lung fluid build-up may qualify in order to reduce the amount of pain.

Ultimately, a physician will decide which patient will benefit the most from pleurodesis treatment. A diagnostic thoracoscopy is mandatory for all patients before a decision for pleurodesis treatment is made.

You can find the full study in the Annals of Thoracic Surgery, Feb. 2015 edition.

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Sources

http://www.uptodate.com/contents/talc-pleurodesis

Rena, O et al, “Persistent Lung Expansion After Pleural Talc Poudrage in Non-Surgically Resected Malignant Pleural Mesothelioma”, February 7, 2015, Annals of Thoracic Surgery, Epub ahead of print