Catheter Tract Metastasis Associated with Indwelling Pleural Catheters.
Chest. 2014 Mar 27;
Authors: Thomas R, Budgeon CA, Kuok YJ, Read C, Fysh ET, Bydder S, Lee YC
ABSTRACT Indwelling pleural catheters (IPC) are commonly used to manage malignant effusions. Tumor spread along the catheter tract remains a clinical concern for which limited data exist. We report the largest series of IPC-related catheter tract metastases (CTM) to date.
METHODS: Single center, retrospective review of IPC inserted over a 44-month period. CTM was defined as a new, solid chest wall lesion over the IPC insertion site and/or the tunneled subcutaneous tract and clinically compatible with a malignant track metastasis.
RESULTS: 110 IPCs were placed in 107 patients (76.6% male; 60% mesothelioma). CTM developed in 11 (10%) cases: nine with MPM and two with metastatic adenocarcinoma. CTM often developed late (median 280 days; range 56-693) post-IPC insertion. Seven cases had chest wall pain and six received palliative radiotherapy to the CTM. Radiotherapy was well tolerated with no major complications and causing no damage to the catheters. Longer interval after IPC insertion was the sole significant risk factor for development of CTM (OR, 2.495; 95%CI 1.247-4.993; p=0.0098) in the multivariate analyses.
CONCLUSION: IPC-related CTM is uncommon but can complicate both mesothelioma and metastatic carcinomas. The duration of interval after IPC insertion is the key risk factor identified for development of CTM. Symptoms are generally mild and respond well to radiotherapy that can be administered safely without removal of the catheter.
PMID: 24676503 [PubMed - as supplied by publisher]