Patient-Reported Outcome Measures in Patients with and without Non-Expandable Lung Secondary to Malignant Pleural Effusion—A Single-Centre Observational Study

Background: Malignant pleural effusion (MPE) affects up to 15% of patients with malignancy,
and the prevalence is increasing. Non-expandable lung (NEL) complicates MPE in up to
30% of cases. However, it is not known if patients with malignant pleural effusion and NEL are
more symptomatic in activities of daily living compared to patients with MPE with expandable lung.
Methods: This was an observational study on consecutively recruited patients with MPE from our
pleural clinic. Before thoracentesis, patients completed patient-reported outcomes on cancer symptoms
(ESAS), health-related quality of life (5Q-5D-5L), and dyspnoea scores. Following thoracentesis,
patients scored dyspnoea relief and symptoms during thoracentesis. Data on focused lung ultrasound
and pleural effusion biochemistry were collected. The non-expandable lung diagnosis was made
by pleural experts based on radiological and clinical information. Results: We recruited 43 patients,
including 12 with NEL (28%). The NEL cohort resembled those from previous studies concerning
ultrasonography, pleural fluid biochemistry, and fewer cases with high volume thoracentesis. Patients
with and without NEL were comparable concerning baseline demography. The 5Q-5D-5L utility
scores were 0.836 (0.691–0.906) and 0.806 (0.409–0.866), respectively, for patients with and without
NEL. We observed no between-group differences in symptom burden or health-related quality of
life. Conclusion: While the presence of NEL affects the clinical management of recurrent MPE, the
presence of NEL seems not to affect patients’ overall symptom burden in patients with MPE.