Mitomycin chemotherapeutic pleurodesis to palliate malignant pleural effusions secondary to gynecological cancer

Background. To assess the efficacy of mitomycin pleurodesis in women with e nd stage malignant effusion. Methods. Retrospective analysis. Results. Of the 13 patients treated six had ovarian, six had endometrial an d one had cervical adenocarcinoma. The median time of onset of effusion fro m diagnosis of primary disease was 12 months (range 1-75). Ten patients wer e evaluable for response. The median age of the patients was 59 years (rang e 42 to 74). Ten (77%) of them had repeated thoracocentesis prior to mitomy cin pleurodesis. The median duration and volume of drainage was 4 days (ran ge 2-11) and 3.1 liters (range 1.2-10.2) respectively. One of two patients developed a pneumothorax and required the insertion of an additional chest drain. Overall, seven patients (70%) responded - one completely (CR) and si x partially (PR), while three did not respond. Four of five patients with o varian cancer had a partial response, two of four patients with endometrial cancer (one CR and one PR) responded. The only patient with cervical cance r had a partial response. Nine patients (69%) had enough symptomatic improv ement to be discharged home, The drug cost of bleomycin 60 units (US$191), another commonly used agent, was more than twice as expensive as mitomycin 30 mg (US$84). Conclusions. Mitomycin pleurodesis can palliate 70% of patients for at leas t 1 month. It offers cheap and effective palliation. There is a suggestion that patients' quality of life is improved.