Objectives: The aim of the presented study was to analyze clinical data of patients with symptomatic malignant pleural effusion due to pleural carcinosis hospitalized at the REGIOMED Clinics and to evaluate and compare outcomes of different local surgical treatment modalities with regards to effectiveness, survival, morbidity as well as duration of hospital stay. Materials and methods: Patients with cytologically or histopathologically proven pleural carcinosis and malignant pleural effusion, hospitalized at any of the REGIOMED Clinics facilities in Germany, from January 2018 to December 2020, were included in this retrospective observational chart-based study. All patients were suffering from dyspnea. Patients were divided into groups according to the type of treatment they received. The aforesaid treatment options are the following: VATS (video-assisted thoracoscopic surgery) pleurodesis (mechanical or chemical) alone or in combination with an indwelling pleural catheter (IPC), combination of VATS and indwelling pleural catheter (IPC), or sole management with an indwelling pleural catheter (IPC). Results: The study included 91 patients, aged between 38 and 90 years. Mean survival time was 138.3 days. No significant differences could be detected between treatment groups regarding the outcome treatment failure, neither initially (P=0.436), nor late treatment failure (P=0.068). In the VATS pleurodesis IPC group, patients experienced significantly more complications compared to the other treatment modalities (OR:3.288, P=0.026). Hypoalbuminemia, systemic therapy as well as successful pleurodesis (r=-0.322, P=0.008; r=0.310, P=0.011; r=0.247, P=0.044 respectively) significantly correlated with survival. In multiple linear regression, hypoalbuminemia persisted as independent predictor of survival (P=0.031). The type of intervention patients underwent showed significant difference regarding duration of hospital stay (P=0.017). Conclusion: Treatment should be individualized and led by an assessment of the patient’s prognosis and driven by a balance of the expected benefit and morbidity of the proposed procedure as well as individual desires of the patient. The ideal method for treating malignant pleural effusion should be simple, effective, and inexpensive, with minimal disturbance to the patient. The survival time is short and expressed in months for patients with MPE. With the continued efforts to improve patient-centered endpoints, the combination of therapies offers promising alternatives over individual therapy alone.