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Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
Lung cancer and ipsilateral pleural effusion
1Servicio de Neumología, Hospital Universitario Virgen del Rocio, Sevilla, Spain.
Summary
Lung cancer with pleural effusion often indicates a poor prognosis. Thoracoscopy helps stage these lung cancer cases, guiding treatment decisions for better patient outcomes.
Area of Science:
- Thoracic Surgery
- Oncology
- Pulmonology
Background:
- Lung cancer with ipsilateral pleural effusion is associated with a poor prognosis.
- Thoracoscopy is a valuable tool for staging lung cancer with pleural effusion before thoracotomy.
- Direct thoracotomy is considered for small or absent effusions, with intraoperative pleural lavage and cytology.
Purpose of the Study:
- To evaluate the utility of thoracoscopy in staging lung cancer with ipsilateral pleural effusion.
- To assess the resectability of lung tumors with and without pleural involvement.
- To determine the success rate of talc pleurodesis in managing non-resectable lung cancer with effusion.
Main Methods:
- Thoracoscopy was performed on 76 patients with lung cancer and ipsilateral pleural effusion.
- Thoracotomy was performed on 167 patients with lung cancer, including those with visceral pleura involvement.
- Talc pleurodesis was administered to patients with non-resectable tumors, with outcomes analyzed based on lung entrapment.
Main Results:
- Thoracoscopy identified only five potentially resectable tumors among 76 patients with effusion; none were resectable upon thoracotomy due to mediastinal invasion.
- Visceral pleura involvement without effusion was found in 31 of 167 thoracotomy patients, with all but one tumor being resectable.
- Talc pleurodesis achieved a 68% success rate in patients without trapped lung versus 56% in those with trapped lung.
Conclusions:
- Thoracoscopy is crucial for accurate staging of lung cancer with pleural effusion, revealing limited resectability in many cases.
- Direct thoracotomy may be more successful for lung cancers with pleural involvement but without effusion.
- Pleural fluid glucose and pH levels are significant predictors for the success of pleurodesis in managing malignant pleural effusion.
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