Cameron D Wright1. 1. Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. cameron@mgh.harvard.edu
Abstract
BACKGROUND: The treatment of locally advanced Masaoka stage IVA thymoma is not standardized and is problematic. METHODS: A single-institution retrospective study was made of 5 patients with World Health Organization B3 thymomas who underwent pleuropneumonectomy for locally advanced thymoma. Two patients had recurrent thymoma and 3 presented de novo with stage IVA disease. Patients had a variety of induction and adjuvant treatments. RESULTS: There was no operative mortality, and only 1 patient had a major complication. Several patients had relatively prolonged disease-free survival. The median survival was 86 months, and the Kaplan-Meier survival was 75% (95% confidence interval: 53% to 97%) at 5 years and 50% (95% confidence interval: 25% to 75%) at 10 years. CONCLUSIONS: Pleuropneumonectomy can be performed safely in patients with advanced thymomas and may improve survival. Highly selected patients might be cured with this approach if a complete resection is performed. While the optimal multimodality strategy for these patients is unknown, induction chemotherapy followed by resection then chemoradiotherapy seems promising.
BACKGROUND: The treatment of locally advanced Masaoka stage IVA thymoma is not standardized and is problematic. METHODS: A single-institution retrospective study was made of 5 patients with World Health Organization B3 thymomas who underwent pleuropneumonectomy for locally advanced thymoma. Two patients had recurrent thymoma and 3 presented de novo with stage IVA disease. Patients had a variety of induction and adjuvant treatments. RESULTS: There was no operative mortality, and only 1 patient had a major complication. Several patients had relatively prolonged disease-free survival. The median survival was 86 months, and the Kaplan-Meier survival was 75% (95% confidence interval: 53% to 97%) at 5 years and 50% (95% confidence interval: 25% to 75%) at 10 years. CONCLUSIONS: Pleuropneumonectomy can be performed safely in patients with advanced thymomas and may improve survival. Highly selected patients might be cured with this approach if a complete resection is performed. While the optimal multimodality strategy for these patients is unknown, induction chemotherapy followed by resection then chemoradiotherapy seems promising.
Authors: Federico Venuta; Erino A Rendina; Marco Anile; Tiziano de Giacomo; Domenico Vitolo; Giorgio F Coloni Journal: Gen Thorac Cardiovasc Surg Date: 2012-01-13
Authors: Giye Choe; Amanda Ghanie; Gregory Riely; Andreas Rimner; Bernard J Park; Manjit S Bains; Valerie W Rusch; Prasad S Adusumilli; Robert J Downey; David R Jones; James Huang Journal: J Thorac Cardiovasc Surg Date: 2019-09-13 Impact factor: 5.209