Predictive Factors for Mortality in Patients with Malignant Pleural effusion Undergoing Pleurodesis via Video-Assisted Thoracoscopy in Senegal

Author(s): Arroye Betou Fabrice Stéphane, Papa Amath Diagne, Laurence Ngo Yon, Charles Mve Mvondo, Endale Mangamba Laurent-Mireille, Ouethy Mireille, Momar Sokhna Diop, Souleymane Diatta, Gabriel Ciss

Background: This study aimed to identify predictive factors for mortality in patients undergoing pleurodesis via video-assisted thoracoscopy surgery

Methods: We conducted a prospective 10-month study including 51 patients with malignant pleural effusion who underwent pleurodesis via video-assisted thoracoscopy at the Department of Thoracic and Cardiovascular Surgery, University Hospital Centre of FANN in Dakar, Senegal. Sociodemographic, clinical, and therapeutic data were collected and analyzed using R software. Kaplan-Meier survival curves and the Cox model were employed to visualize survival probabilities and identify predictive factors for mortality.

Results: The mean age of patients was 50 ± 14 years, with a predominance of female patients (66.7% vs. 33.3%). The prevalence of malignant pleurisy was 49% (n = 25) for recurrent right-sided pleural effusion, 43% (n = 22) for recurrent left-sided pleural effusion, and 7.8% (n = 4) for recurrent bilateral pleurisy, with a mortality rate of 18% (n = 9). Occupational exposure (p = 0.015) and the use of traditional surgical techniques (p = 0.005) were significantly associated with reduced survival at 24 weeks. Predictive factors for mortality included sex (HR = 0.95; p = 0.02), the presence of comorbidities (HR = 0.98; p = 0.007), positive cytology (HR = 0.7; p = 0.02), and chemotherapy treatment (HR = 0.95; p = 0.04).

Conclusion: Our results show that factors such as sex, the presence of comorbidities, positive cytology, and the use of chemotherapy significantly influence patient survival. It is necessary to establish a multidisciplinary approach and increase access to the most appropriate diagnostic and therapeutic methods to optimize the survival of patients with malignant pleural effusion.