Management of malignant airway obstruction

Malignant central airway obstruction (MCAO) is an important manifestation of advanced primary lung cancer or metastatic disease and has a significant impact on both morbidity and mortality. Several minimally invasive endobronchial techniques exist which can provide rapid recanalization of the airway and improve a patient’s quality of life and potentially overall survival by improving candidacy for systemic or surgical therapies. Modalities for the management of MCAO include thermal ablative techniques, non-thermal techniques, mechanical debulking, and airway stent placement. These therapies are not without complications and as such, the risks and benefits of each intervention should be weighed and individualized to a patient’s particular need. Though large randomized trials are lacking, data show that in experienced hands, multimodality therapy in MCAO can provide significant overall symptom palliation.