A Crnjac

A Hojski

Journal of Cardiothoracic Surgery

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ORAL PRESENTATION Open AccessA scientific basis to determine the best paliativetreatment for malignant pleural effusionA Hojski*, A CrnjacFrom 23rd World Congress of the World Society of Cardio-Thoracic SurgeonsSplit, Croatia. 12-15 September 2013BackgroundThe purpose of our study is to determine the role of growthfactors (GF) in the process of pleurodesis. Biochemicalcharacteristics of the pleural effusion (PE) are an importantprognostic factor. Published data on the role of GF inthe formation of PE and its treatment is somewhatcontradictory.MethodsA prospective randomized study included 40 femalepatients with malignant PE resulting from breast carci-noma. They were divided into two groups and treated bymeans of mechanical (MP) or chemical (CP) pleurodesis.Samples of pleural fluid were analyzed by ELISA. Thestudy was approved by the National Ethics Committee.ResultsWe found a 2.5 times increase in VEGF levels inthe serum when performing a CP and a less than25% increase of its original value in MP group. The aver-age serum level of VEGF before receiving CP was458.65 ng/ml (172-702 ng/ml) and was elevated to amean level of 1197.65ng/ml (406-2011ng/ml). In theMP group same results for serum VEGF were found517.55 ng/ml (73-976 ng/ml) and 632.24 ng/ml (111 –1136 ng/ml). Peak levels were noted between 24 and48 hours after performing pleurodesis.Of the GF secreted, particularly VEGF was present inexcess. Serum VEGF could be the cause of some of theside effects we are faced with when performing CP.The relationship between the released GF in MP issomewhat different. Namely, it has less influence onserum VEGF levels. We also believe that a proteoglycanbound FGF which is found in basal membrane might bethe key to an effective pleurodesis.ConclusionsIt is important to understand that the current knowledgeof the effects of GF combined with our findings representsa contraindication for CP. Excess concentration of VEGFcreates an environment that promotes the formation ofPE, growth of tumor tissue and acts as a mediator ofinflammation, possibly resulting in ARDS. We propose touse the MP as an effective, harmless and inexpensivemethod.Published: 11 September 2013doi:10.1186/1749-8090-8-S1-O239Cite this article as: Hojski and Crnjac: A scientific basis to determine thebest paliative treatment for malignant pleural effusion. Journal ofCardiothoracic Surgery 2013 8(Suppl 1):O239.Submit your next manuscript to BioMed Centraland take full advantage of: • Convenient online submission• Thorough peer review• No space constraints or color figure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionSubmit your manuscript at www.biomedcentral.com/submit* Correspondence: aljaz.hojski@ukc-mb.siDepartment of Thoracic Surgery, Division of Surgery, University MedicalCentre Maribor, Maribor, SloveniaHojski and Crnjac Journal of Cardiothoracic Surgery 2013, 8(Suppl 1):O239http://www.cardiothoracicsurgery.org/content/8/S1/O239© 2013 Hojski and Crnjac; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited.

A scientific basis to determine the best paliative treatment for malignant pleural effusion

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A scientific basis to determine the best paliative treatment for malignant pleural effusion

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