Effectiveness of argon plasma coagulation in patients with haemoptysis caused by malignancies

Patients with central neoplasms and haemoptysis show low survival rates. Symptom control without recurrence 48 hours after bronchoscopic interventions may improve the prognosis of these patients. Bronchoscopic Argon Plasma Coagulation (APC) is a useful technique for endobronchial management of haemoptysis. Nevertheless, limited data are available in the literature on its efficacy and safety and the main predictors of success are still unclear. The aim of the study was to analyse the cessation of haemorrhage without recurrence at 48 hours after bronchoscopic APC in the treatment of patients with haemoptysis caused by endobronchial neoplasms by evaluating its efficacy and the main predictors of success. This is an observational, prospective, single-centre cohort study conducted in Italy from August 2018 to July 2023. A total of 76 patients with median age 75 years (IQR: 65-79) were enrolled. 67 (88.2%) patients had bleeding cessation without recurrence 48 hours after bronchoscopic APC. A low rate of non-serious adverse events (5.3%) was recorded and a low (7.6%) recurrence rate of haemoptysis at 3.5 months after the procedure was also shown. No clinical, demographic and endoscopic variables related to a successful procedure at 48 hours were found. In conclusion this study demonstrates that bronchoscopic APC is an effective procedure in the treatment of patients with haemoptysis caused by endobronchial malignancies, regardless of the clinical characteristics of the patients, the endoscopic and histological features of the neoplasm and the severity of the symptom. Furthermore, it shows a low rate of complications and long-term efficacy in bleeding control.