Surgical management options in lung cancer with malignant pleural disease

Abstract

This review discusses surgical management options, both radical and palliative surgical management for malignant pleural disease in lung cancer. No current clinical guideline recommends their routine implementation. Nevertheless, radical surgical management is used to improve the long-term results for patients with malignant pleural disease. The observational data suggest the effectiveness is not apparent, which is also associated with the patients’ heterogeneity and surgical methods. Most experts agree that it is impossible to draw well-grounded conclusions about the feasibility, efficacy, safety and optimal scope for surgical interventions in lung cancer patients with malignant pleural diseases. They advocate further research and randomised trials, considering the expected potential of using modern multidisciplinary approaches. When determining the tactics of malignant pleural disease management, an individual approach is required. It is crucial to consider the most significant prognostic and predictive factors: laterality, tumour spread (distant and regional metastases), sex, age, comorbidities, morphology, the presence of driver mutations, and the risk of postoperative complications. Personalisation of methods for managing malignant pleural disease in lung cancer is a promising area of modern oncology. However, many aspects of approaches to solving this problem remain unclear and require further research.