Talc pleurodesis versus indwelling pleural catheter for refractory pleural effusion: a prospective study of survival and complications

A significant trade-off exists between the two procedures. IPC is associated with shorter hospitalization and fewer acute complications, while TP offers definitive effusion control. The observed survival difference in the TP group appears to be driven by the selection of fitter patients with better performance status for the more invasive procedure, rather than a direct therapeutic benefit of talc. Treatment decisions must be individualized, weighing patient prognosis and performance status.