Effectiveness and Safety of Talc Slurry Pleurodesis in the Treatment of Patients with Malignant Pleural Effusion and Low Karnofsky Performance Status Scores

<b>Background/Objectives</b>: Malignant pleural effusion is a common and distressing complication of advanced cancer, often resulting in severe symptoms such as dyspnoea, which significantly impacts patients' quality of life. This study evaluates the effectiveness and safety of talc slurry pleurodesis as a palliative treatment for recurrent malignant pleural effusion and examines predictive factors for pleurodesis success and survival. <b>Methods</b>: A single-centre cohort study was conducted at the Thoracic Surgery Department of the University Clinical Centre of Kosovo between April 2022 and March 2024. The study included adult patients with recurrent and symptomatic malignant pleural effusion who met specific inclusion criteria for performing pleurodesis. Patients were followed prospectively with routine clinical evaluations until the conclusion of the study on 9 September 2024. Descriptive and inferential statistics were employed to evaluate the success of pleurodesis and its associated outcomes. <b>Results</b>: The study shows a success rate of 84.6% at 30 days post-procedure, with 57.6% achieving complete success and 42.4% partial success. Talc slurry pleurodesis was associated with minimal complications, with chest pain and fever being the most common adverse effects. The most significant predictors of survival post-pleurodesis identified were the Karnofsky Performance Status score and serum neutrophil-to-lymphocyte ratio. Patients with higher Karnofsky Performance Status scores and lower neutrophil-to-lymphocyte ratios had improved survival outcomes. <b>Conclusions</b>: This study suggests that talc slurry pleurodesis is an effective and safe option for managing malignant pleural effusions in patients with low-performance status, offering symptom relief and potentially extending survival in certain patients. Further research is required to refine predictive models for treatment success.