Pleuroscopy First Versus Thoracentesis First in Patients With Suspected Malignant Pleural Effusions

Summary

This is a randomized control trial of patients with suspected malignant pleural effusions to compare whether patients who have a thoracentesis or pleuroscopy (pleural biopsy) obtain an adequate biopsy, achieve a diagnosis, and begin cancer-directed therapy faster.

Eligibility

Inclusion Criteria:

* Referral for diagnostic pleural procedure.
* Age ≥ 18 years.
* Suspected malignant pleural effusion (Suggestive radiologic appearance (based on computed tomography or positron emission tomography) OR suspected cancer with associated effusion.)

Exclusion Criteria:

* Inability to provide informed consent.
* Needs emergent drainage.
* Pleural effusion is known to be malignant.
* Suspected transudative, infectious or inflammatory effusion etiology.
* Having prior inconclusive/non-diagnostic thoracentesis or pleuroscopy.
* Patient is deemed by the clinical team to be more appropriate for VATS biopsy.
* Terminally ill patients in whom a diagnosis will not change management, or who is unlikely to be a candidate for oncological treatment due to significant comorbidities.
* Pregnancy

Conditions2

Locations2 sites

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