Pleural effusion: malignant: lung and breast were the commonest primaries.

Clinical bottom line (level 4)

  1. The commonest primary sites for malignant pleural effusions were the lung and breast.
Chernow and Sahn: American Journal of Medicine 1977; 63: 695-701
Expires October 2003

The study

Case series with ?objective ?blinded outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: university hospital, USA (1960 to 1975)

96 patients (aged range 31 to 80 years; mean 58, 64% female) pleural effusions due to malignant involvement of the pleura (diagnosed by cytology of pleural fluid or by pleural biopsy)


100% followed for until discharge or death
Outcomes studied:
  • site of primary: lung
  • breast
  • ovary
  • stomach
  • pancreas
  • colon
  • prostate

    • final diagnosis: based on hospital records and autopsy

    The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    site of primary: lung until discharge or death 32/96 33%
    (24% to 43%)
    breast until discharge or death 20/96 21%
    (13% to 29%)
    ovary until discharge or death 9/96 9.4%
    (3.5% to 15%)
    stomach until discharge or death 7/96 7.3%
    (2.1% to 21%)
    pancreas until discharge or death 3/96 3.1%
    (0.0% to 6.6%)
    colon until discharge or death 3/96 3.1%
    (0.0% to 6.6%)
    prostate until discharge or death 2/96 2.1%
    (0.0% to 4.9%)

    Citation

    1. Chernow B, and Sahn SA: Carcinomatous involvement of the pleura: an analysis of 96 patients. American Journal of Medicine 1977; 63: 695-701
    Search Terms: reference from Pleural effusion chapter in 'Quick Consult Manual to Evidence-based Medicine': publd. Lippincott-Raven, 1997
    Contributor: Chris Ball and Clare Wotton, October 2000
    Reviewer:

    Clinical Question.
    Patient malignant pleural effusion
    Intervention or Exposure prevalence
    Outcome common primary sites