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Comment & Response
April 10, 2018

Treatment Approaches for Malignant Pleural Effusion

Author Affiliations
  • 1Department of Palliative Medicine, National Cancer Center Hospital East, Chiba, Japan
  • 2National Cancer Center Hospital East, Chiba, Japan
  • 3Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
JAMA. 2018;319(14):1506-1507. doi:10.1001/jama.2018.1319

To the Editor Dr Thomas and colleagues1 reported that among patients with malignant pleural effusion, treatment with an indwelling pleural catheter vs talc pleurodesis resulted in significantly fewer hospitalization days from treatment to death (median, 10 d vs 12 d; P = .03). Interventions that aim to decrease hospitalizations in terminally ill patients may enhance their quality of life and minimize caregivers’ bereavement-related distress.2 The authors stated that the observed 2-day difference was of uncertain clinical importance; however, it is necessary to consider the patient’s remaining days of life to interpret the duration meaningfully. Although 2 days may be negligible for patients with a relatively long-term prognosis, it might be indispensable for patients with limited-term prognosis. Therefore, it will be essential to know additional information when making a choice between an indwelling pleural catheter or talc pleurodesis in daily clinical practice.