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非小细胞肺癌伴有恶性胸膜播散临床分期属于Ⅳ（M1a）期，因其已发生远处转移，预后不良，其主要治疗方法包括化疗、靶向治疗、姑息支持治疗，外科治疗通常为禁忌。然而部分经过高度筛选患者仍可能通过外科治疗改善预后，部分患者甚至可获得较长期生存。筛选T和 N分期较早、恶性胸膜结节较局限和恶性胸腔积液量较少（＜300 mL）的患者行包含肿瘤原发灶切除的外科治疗可能使患者获益，进一步了解预后相关因素将更有利于发挥外科治疗益处。“,”Non-small cell lung cancer with confirmed pleural dissemination is staged Ⅳ( M1a) in the new staging system,and it is generally contraindicated for surgery due to the distant metastasis and poor prog-nosis,and chemotherapy,targeted therapy and palliative support therapy are the main treatments .Some highly selected patients may benefit from surgical treatment and even achieve long-term survival in a few cases. Patients with earlier T and N stage ,limited and localized malignant pleural nodules and little malignant pleu-ral effusion( <300 mL) are more likely to get survival benefit from tumor resection .A better understanding of the related prognostic factors may help improve surgical interventions .