Outcome of Tetracycline Pleurodesis in Patients with Malignant Pleural Effusion

Abstract

Background: Malignant pleural effusion commonly complicates advanced malignancies which significantly impact patient quality of life. Tetracycline pleurodesis is frequently utilized in resource-limited settings due to its availability and cost-effectiveness. However, recent local data regarding its efficacy and safety remain sparse.

Objective: To determine the outcome of tetracycline pleurodesis in patients with malignant pleural effusion.

Methods: This descriptive study was conducted over six months at Lady Reading Hospital, Peshawar. A total of 89 patients aged 31–77 years with cytologically confirmed MPE underwent chemical pleurodesis using tetracycline. Data were collected on demographics, malignancy type and duration, effusion volume, and pleurodesis outcomes. The primary outcome of this study was pleurodesis success (no effusion recurrence at 30 days). Secondary outcomes included post-procedure chest pain and fever. Stratified analysis was performed by age, sex, malignancy type, duration, and effusion volume.

Results: Pleurodesis was successful in 67 of 89 patients (75.3%). Post-procedural chest pain and fever were found in 22.5% and 20.2%, respectively; all episodes were short term. Stratified analysis showed no statistically significant predictors of pleurodesis outcome (p > 0.05 for all variables). No mortality or serious complications were observed.

Conclusion: Tetracycline pleurodesis achieved successful short-term control of MPE in approximately three-quarters of patients with low complication rates. These findings support the use of tetracycline as an effective and accessible sclerosant in palliative care settings, especially where other options are unavailable.