Jean Michel Maury1, Nicolas Girard2, Mayeul Tabutin3, Renaud Grima4, Lara Chalabreysse5, Isabelle Pavlakovic6, Annie Sayag-Beaujard6, Caroline Leroux7, Pierre-Jean Souquet8, Olivier Glehen9, François Tronc1. 1. Department of Thoracic Surgery, Louis Pradel Hospital, Hospices Civils de Lyon, F-69677 Lyon, France; Université de Lyon, Université Lyon 1, INRA, UMR754, UMS 3444, SFR BioSciences, F-69007 Lyon, France. 2. Université de Lyon, Université Lyon 1, INRA, UMR754, UMS 3444, SFR BioSciences, F-69007 Lyon, France; Department of Respiratory Medicine, Louis Pradel Hospital, Hospices Civils de Lyon, F-69677 Lyon, France. Electronic address: nicolas.girard@chu-lyon.fr. 3. Department of Thoracic Surgery, Louis Pradel Hospital, Hospices Civils de Lyon, F-69677 Lyon, France; Department of Surgery, Centre Léon-Berard, Cancer Research Center of Lyon 28, F-69008 Lyon, France. 4. Department of Thoracic Surgery, Louis Pradel Hospital, Hospices Civils de Lyon, F-69677 Lyon, France. 5. Université de Lyon, Université Lyon 1, INRA, UMR754, UMS 3444, SFR BioSciences, F-69007 Lyon, France; Department of Pathology, Louis Pradel Hospital, Hospices Civils de Lyon, F-69677 Lyon, France. 6. Department of Anesthesiology and Reanimation, Louis Pradel Hospital, Hospices Civils de Lyon, F-69677 Lyon, France. 7. Université de Lyon, Université Lyon 1, INRA, UMR754, UMS 3444, SFR BioSciences, F-69007 Lyon, France. 8. Department of Respiratory Medicine, Lyon Sud Hospital, Hospices Civils de Lyon, F-69495 Pierre Benite, France. 9. Departement of General Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, F-69495 Pierre Benite, France.
Abstract
BACKGROUND: Pleural recurrences are a hallmark of thymomas, and represent a challenge for multidisciplinary management. The purpose of this study was to assess the feasibility and the results in terms of morbidity, mortality and survival rates, of Intra-Thoracic Chemo-Hyperthermia (ITCH) for the treatment of pleural recurrences of thymomas. METHODS: Retrospective analysis of 19 consecutives patients between 1997 and 2015 treated by surgical cytoreduction (pleurectomy) followed by ITCH with 25mg/m2 of mitomycin, and 50mg/m2 of Cisplatin. RESULTS: There were 8 men and 11 women with a median age of 44 years. ITCH was combined with pleurectomy alone in 4 (22%) patients, pleurectomy and wedge resections in 14 (74%) patients; 1 (5%) patient had a pleuropneumonectomy. There were no perioperative deaths, and 5 patients (26%) presented with postoperative complication, including 3 (16%) cases related to chemotherapy (one case of reversible grade 2 bone marrow aplasia, and 2 cases of reversible, acute kidney failure). The median length of stay in intensive care unit and hospital were 1day and 10days, respectively. After a median follow-up period of 39 months (range 10-127 months), median disease-free survival was 42 months. Five patients (26%) died during follow-up. CONCLUSIONS: Our data indicate that ITCH is a feasible option for selected patients with pleural recurrence of thymomas. ITCH clearly provides long local control, without major safety issues, and prolonged survival may be achieved in selected patients. This therapeutic option should be discussed at a multidisciplinary tumor board.
BACKGROUND:Pleural recurrences are a hallmark of thymomas, and represent a challenge for multidisciplinary management. The purpose of this study was to assess the feasibility and the results in terms of morbidity, mortality and survival rates, of Intra-Thoracic Chemo-Hyperthermia (ITCH) for the treatment of pleural recurrences of thymomas. METHODS: Retrospective analysis of 19 consecutives patients between 1997 and 2015 treated by surgical cytoreduction (pleurectomy) followed by ITCH with 25mg/m2 of mitomycin, and 50mg/m2 of Cisplatin. RESULTS: There were 8 men and 11 women with a median age of 44 years. ITCH was combined with pleurectomy alone in 4 (22%) patients, pleurectomy and wedge resections in 14 (74%) patients; 1 (5%) patient had a pleuropneumonectomy. There were no perioperative deaths, and 5 patients (26%) presented with postoperative complication, including 3 (16%) cases related to chemotherapy (one case of reversible grade 2 bone marrow aplasia, and 2 cases of reversible, acute kidney failure). The median length of stay in intensive care unit and hospital were 1day and 10days, respectively. After a median follow-up period of 39 months (range 10-127 months), median disease-free survival was 42 months. Five patients (26%) died during follow-up. CONCLUSIONS: Our data indicate that ITCH is a feasible option for selected patients with pleural recurrence of thymomas. ITCH clearly provides long local control, without major safety issues, and prolonged survival may be achieved in selected patients. This therapeutic option should be discussed at a multidisciplinary tumor board.
Authors: Gabrielle Drevet; Stéphane Collaud; François Tronc; Nicolas Girard; Jean-Michel Maury Journal: Cancer Manag Res Date: 2019-07-22 Impact factor: 3.989
Authors: Till Markowiak; Michael Koller; Florian Zeman; Gunnar Huppertz; Hans-Stefan Hofmann; Michael Ried Journal: BMJ Open Date: 2020-07-20 Impact factor: 2.692