Wolf Andrea S, Flores Raja M
Department of Thoracic Surgery, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1023, New York, NY 10029, USA.
Department of Thoracic Surgery, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1023, New York, NY 10029, USA.
Thorac Surg Clin. 2014 Nov;24(4):471-5. doi: 10.1016/j.thorsurg.2014.07.014. Epub 2014 Oct 23.
Although originally performed on patients with refractory tuberculosis and malignant pleural mesothelioma, extrapleural pneumonectomy may be used to treat patients with pleural dissemination of other malignancies, including thymoma and NSCLC. Patients who present with stage IV NSCLC caused by malignant pleural effusion may be considered for EPP following induction chemotherapy if they demonstrate no mediastinal nodal or distant metastases and have adequate cardiopulmonary reserve. EPP for NSCLC should be performed by experienced teams at experienced centers to minimize the morbidity and mortality associated with this radical procedure. Additional prospective studies are needed to better characterize the role of EPP in the multimodality treatment of patients with pleural dissemination of malignancy, including NSCLC.
尽管胸膜外全肺切除术最初是用于治疗难治性肺结核和恶性胸膜间皮瘤患者，但它也可用于治疗其他恶性肿瘤胸膜播散的患者，包括胸腺瘤和非小细胞肺癌（NSCLC）。如果恶性胸腔积液导致的IV期NSCLC患者在诱导化疗后未出现纵隔淋巴结转移或远处转移且有足够的心肺储备，则可考虑行胸膜外全肺切除术。NSCLC的胸膜外全肺切除术应由经验丰富的中心的经验丰富的团队进行，以尽量减少与这种根治性手术相关的发病率和死亡率。需要更多的前瞻性研究来更好地明确胸膜外全肺切除术在包括NSCLC在内的恶性肿瘤胸膜播散患者的多模式治疗中的作用。
