Optimising the use of indwelling pleural catheter in the management of malignant pleural effusion

This PhD thesis explores key knowledge gaps about the benefits and safety of indwelling pleural catheters (lPC) in the treatment for malignant pleural effusions (MPEs).The major findings include i. lPC patients spent significantly fewer days in hospital compared to those who had talc pleurodesis (Australasian Malignant Pleural Effusion randomised trial); ii. lPC-related complications of symptomatic loculation and catheter tract metastasis were effectively treated by fibrinolytics and radiotherapy respectively; and iii. Pleural fluid biochemistry and cytokines change significantly with cancer progression. These novel results support the use of lPCs as first-line therapy and set the platform for future MPE research.