Management of occult malignant pleural disease firstly detected at thoracotomy for non-small cell lung cancer patients

Non-small cell lung cancer (NSCLC) patients with malignant pleural disease (MPD), which includes malignant pleural effusion (MPE) and/or malignant pleural nodules (MPN), are generally considered to be inoperable and the prognosis of this disease has remained persistently bad during the last 30 years (1-3). MPD is often discovered at thoracotomy for the NSCLC patients, and the treatment of primary cancer lesion is always controversial (4-8)