[Treatment of pleural metastases in an interdisciplinary concept]

A retrospective examination involved 414 patients (260 m, 154 w, mean 60 y) with pleural metastasis/pleural effusion of the following primary tumors: 37.2% bronchogenic (23.2% malignant pl. mesothelioma), 14.5% breast, 8.7% adeno-ca (unknown primary) 2.4% gastrointestinal, 2.2% uterus/ovar, and 11.8% others. Thoracoscopy with histologic confirmation played a central role in our diagnostic procedures in 97% of the cases. Malignancy was defined by CEA (less than 5 mg/ml) (71.9%) and cytology (76.9%) in 90.4%. Our strategy had the following success rate: desiccation by pleural drainage (greater than 26 Charr) alone 74%, in combination with pleurodesis 81%, pleurectomy/decortication 95%, and extended pleuropneumonectomy (in 80% mesothelioma) 96%.