The results demonstrate that low PH (HR 1.95; 95% CI 1.46–2.60), low glucose (HR 1.75; 95% CI 1.18–2.61), high LDH (HR 1.47; 95% CI 1.18–1.84), high VEGF (HR 1.99; 95% CI 1.67–2.37) and high survivin (HR 2.90; 95% CI 1.17–7.20) in pleural effusion are prognostic risk factors in OS for malignant patients. Here, BIRC5 is linked to Pleural effusion.