Surgical cytoreduction and hyperthermic intrathoracic chemotherapy for thymic tumours with pleural spread is effective on survival: results from the multicentre German hyperthermic intrathoracic chemotherapy study

URN to cite this document:

urn:nbn:de:bvb:355-epub-586090 Copy

DOI to cite this document:

10.5283/epub.58609 Copy

Ried, Michael ; Hassan, Mohamed ; Passlick, Bernward ; Schmid, Severin ; Markowiak, Till ; Müller, Karolina ; Huppertz, Gunnar ; Koller, Michael ; Winter, Hauke ; Klotz, Laura V. ; Hatz, Rudolf ; Kovács, Julia ; Zimmermann, Julia ; Hofmann, Hans-Stefan ; Eichhorn, Martin E.

License: Creative Commons Attribution 4.0 PDF - Published Version (958kB)

Date of publication of this fulltext: 04 Jul 2024 10:30

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Details

Item type:	Article
Open Access Type:	Gold (with APC)
Journal or Publication Title:	Interdisciplinary CardioVascular and Thoracic Surgery
Publisher:	Oxford University Press (OUP)
Place of Publication:	OXFORD
Volume:	36
Number of Issue or Book Chapter:	6
Date:	10 February 2023
Institutions:	Medicine > Abteilung für Thoraxchirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien
Projects (Historical):	DFG, RI 2905/3-1; project number: 433397011
Identification Number:	Value Type 10.1093/icvts/ivad032 DOI
Keywords:	CLASSIFICATION; PERFUSION; RESECTION; SURGERY; THYMOMA; MALIGNANCIES; MANAGEMENT; PROPOSAL; Hyperthermic intrathoracic chemotherapy; Thymic tumour; Thymic carcinoma; Cytoreductive surgery
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	58609

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Abstract

OBJECTIVES: Cytoreductive surgery and hyperthermic intrathoracic chemotherapy (HITOC) is effective on survival for patients with pleural metastatic thymic tumours.METHODS: Multicentre, retrospective analysis of patients with stage IVa thymic tumours treated with surgical resection and HITOC. Primary end point was overall survival, secondary end points were recurrence-/progression-free survival ...

Abstract

OBJECTIVES: Cytoreductive surgery and hyperthermic intrathoracic chemotherapy (HITOC) is effective on survival for patients with pleural metastatic thymic tumours.METHODS: Multicentre, retrospective analysis of patients with stage IVa thymic tumours treated with surgical resection and HITOC. Primary end point was overall survival, secondary end points were recurrence-/progression-free survival and morbidity/mortality.RESULTS: A total of n = 58 patients (thymoma, n = 42; thymic carcinoma, n = 15; atypical carcinoid of the thymus, n = 1) were included, who had primary pleural metastases (n = 50; 86%) or pleural recurrence (n = 8; 14%). Lung-preserving resection (n = 56; 97%) was the preferred approach. Macroscopically complete tumour resection was achieved in n = 49 patients (85%). HITOC was performed with cisplatin alone (n = 38; 66%) or in combination with doxorubicin (n = 20; 34%). Almost half of the patients (n = 28; 48%) received high-dose cisplatin > 125 mg/m(2) body surface area. Surgical revision was required in 8 (14%) patients. In-hospital mortality rate was 2%. During follow-up, tumour recurrence/progression was evident in n = 31 (53%) patients. Median follow-up time was 59 months. The 1-, 3- and 5-year survival rates were 95%, 83% and 77%, respectively. Recurrence/progression-free survival rates were 89%, 54% and 44%, respectively. Patients with thymoma had significantly better survival compared to patients with thymic carcinoma (P-value =0.001).CONCLUSIONS: Promising survival rates in patients with pleural metastatic stage IVa in thymoma (94%) and even in thymic carcinoma (41%) were achieved. Surgical resection and HITOC is safe and effective for treatment of patients with pleural metastatic thymic tumours stage IVa.

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