| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | The Thoracic and Cardiovascular Surgeon | ||||
| Publisher: | GEORG THIEME VERLAG KG | ||||
| Place of Publication: | STUTTGART | ||||
| Volume: | 62 | ||||
| Number of Issue or Book Chapter: | 02 | ||||
| Page Range: | pp. 161-168 | ||||
| Date: | 2013 | ||||
| Institutions: | Medicine > Abteilung für Thoraxchirurgie | ||||
| Identification Number: |
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| Keywords: | HYPERTHERMIC INTRATHORACIC CHEMOTHERAPY; THYMIC EPITHELIAL TUMORS; CYTOREDUCTIVE SURGERY; EXTRAPLEURAL PNEUMONECTOMY; CLINICAL-EXPERIENCE; SINGLE-INSTITUTION; PROGNOSTIC-FACTORS; MALIGNANT THYMOMA; PLEURAL SPREAD; PERFUSION; thymoma; thymic carcinoma; pleurectomy; decortication; hyperthermic intrathoracic chemotherapy | ||||
| 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: | 61686 |
Web of ScienceAbstract
ObjectiveExtended thymoma resections including adjacent structures and pleurectomy/decortication (P/D) with hyperthermic intrathoracic chemotherapy (HITHOC) perfusion were performed in a multidisciplinary treatment regime. Patients and MethodsBetween July 2000 and February 2012, 22 patients with Masaoka stage III (n=9; 41%) and Masaoka stage IVa (n=13; 59%) thymic tumors were included. ...
Abstract
ObjectiveExtended thymoma resections including adjacent structures and pleurectomy/decortication (P/D) with hyperthermic intrathoracic chemotherapy (HITHOC) perfusion were performed in a multidisciplinary treatment regime. Patients and MethodsBetween July 2000 and February 2012, 22 patients with Masaoka stage III (n=9; 41%) and Masaoka stage IVa (n=13; 59%) thymic tumors were included. ResultsMean age was 55 years (25-84 years) and 50% (11 out of 22) of patients were female. World Health Organization histological classification was as follows: B2 (n=15), A (n=1), B1 (n=1), B3 (n=2), and thymic carcinoma (C; n=3). Radical thymectomy and partial resection of the mediastinal pleura and pericardium were performed. Of the 13, 9 patients with pleural involvement (stage IVa) received radical P/D followed by HITHOC (cisplatin). Macroscopic complete resection (R0/R1) was achieved in 19 (86%) patients. All patients received multimodality treatment depending on tumor stage, histology, and completeness of resection. Thirty-day mortality was 0% and three (13.6%) patients needed operative revision. Recurrence of thymoma was documented in five (22.7%) patients (stage III, n=1; stage IVa, n=4). Mean disease-free interval of patients with complete resection (n=14 out of 22) was 30.2 months. After a mean follow-up of 29 months, 18 out of the 22 (82%) patients are alive. After P/D and HITHOC, 89% (8 out of 9 patients) are alive (current median survival is 25 months) without recurrence. ConclusionsExtended surgical resection of advanced thymic tumors infiltrating adjacent structures (stage III) or with pleural metastases (stage IVa) is safe and feasible. It provides a low recurrence rate and an acceptable survival. Additional HITHOC in patients with pleural thymoma spread seems to offer a better local tumor control.
Metadata last modified: 19 Dec 2024 08:12
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