RT Journal Article SR Electronic T1 Outpatient management of malignant pleural effusion in patients unfit for pleurodesis JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA2527 DO 10.1183/13993003.congress-2016.PA2527 VO 48 IS suppl 60 A1 Luca Bertolaccini A1 Andrea Viti A1 Simona Paiano A1 Luca Rosario Assante A1 Carlo Pomari A1 Alberto Terzi YR 2016 UL http://erj.ersjournals.com/content/48/suppl_60/PA2527.abstract AB BACKGROUND: Multidisciplinary cancer teams regularly treat patients with Malignant Pleural Effusion(MPE)Uniportal VATS talc poudrage is the standard of care for fit patients being talc slurry reserved to unfit for surgeryAIMS: In patients unfit for pleurodesis (low-performance status/comorbidity),recurrent MPE after pleurodesis,trapped lung,outpatient management through subcutaneous tunneled indwelling pleural catheter (IPC) could be usedMETHODS: From 2001, 189 patients referred for IPC with histological/cytological confirmed MPEContraindications: mesothelioma,coagulopathy,skin infection,loculated effusionsIPC placed under local anesthesiaWeekly fluid evacuation recommendedDistrict nurses management on outpatientRESULTS: All reported reduction in dyspnea/improvement of well-beingAll discharged in the same implantation dayMinor complications in 9% (no IPC metastatic seeding)Mean duration of drainage 54 days (range 21-296)Pleurodesis achieved in 81 (42.9%) after median time of 54 days (range 31-83)Mean survival 184 days (range 21-296)Demographic characteristicsMean age, years (range)67 (43 – 86)M/F (%)69.3Primary malignancy, No. (%)Non-small cell lung cancer98 (51.9)Digestive tract38 (20.1)Breast23 (12.2)Ovarian15 (7.9)Unknown primary9 (4.8)Hematologic malignancies6 (3.1)Side of implantation, No. (%)Right108 (57.2)Left69 (36.5)Bilateral12 (6.3)Discharged to, No. (%)Home176 (93.1)Another institution13 (6.9)Complications, No. (%)Pain during drainage, no (%) 5 (5.6%)13 (6.3)Local infection3 (1.6)Catheter dislocation1 (0.5)CONCLUSIONS: In end-stage cancers, treatment of MPE with IPC improves quality of lifeComplication rate is low and IPC can be safely managed at home.