Surgical palliation of airway obstruction resulting from lung cancer

Bronchogenic carcinoma remains a relentless plague of modern society causin g far more deaths than the well-popularized "AIDS epidemic" and secondary o nly to cardiovascular disease as a cause of death in America. Despite medic al advances and treatment breakthroughs, only 40% of newly identified lung cancer patients are "potentially curable". Therefore, a large portion of th is patient population will require palliative care and treatment. Surgical palliation is somewhat a misnomer in that most endobrachial lesions causing significant obstruction that result in dyspnea are not amenable to surgica l intervention, i.e., operative resectional therapy. The palliative managem ent options of airway obstruction re suiting from advanced stage lung cance r will be reviewed, including the historical aspects, development and curre nt use of laser resection, airway stenting, and endobrachial brachytherapy for management of unresectable airway tumors. These modalities frequently a re used simultaneously in the same patient and may be used in conjunction w ith current chemotherapeutic and conventional external-beam radiation proto cols. (C) 2000 Wiley-Liss, Inc.