Factors Affecting Rate of Pleural Fluid Accumulation in Patients with Malignant Pleural Effusions

Abstract Purpose of Review Malignant pleural effusions (MPEs) are initially treated with thoracocentesis but usually reaccumulate. There is wide variation in the rate recurrence. Those rapid recurrence could benefit from early definitive treatment, whilst those slower recurrences may not. Here, we discuss fluid homeostasis, MPE pathophysiology, and factors associated reaccumulation. Recent Findings Few studies have investigated markers Suggested features reaccumulation include lactate dehydrogenase, effusion size, positive cytology, dyspnoea. Vascular endothelial growth factor (VEGF) correlates size treatment response, its association unknown. Some anti-VEGF therapies shown promise management. Summary Further work needed to validate hypothesised biomarkers characterise other biomarkers, such as VEGF. The Reaccumulation Pleural Effusions After Therapeutic Aspiration (REPEAT) study aims address these gaps literature currently recruitment.