Clinical Outcomes of Up-front Surgery Versus Surgery After Induction Chemotherapy for Thymoma and Thymic Carcinoma: A Retrospective Study

Ma, Weili; Lin, Chia‐Chi; Hsu, Feng‐Ming; Lee, Jang-Ming; Chen, Jin‐Shing; Hsieh, Min‐Shu; Chang, Yih‐Leong; Chao, Yuan-Hung; Chang, Chung-I; Yang, James Chih‐Hsin

doi:10.1016/j.cllc.2019.06.011

Cited by 11 publications

(9 citation statements)

References 28 publications

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“…The present study included five RCT and eight cohort studies (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), and the results showed that thoracoscopic surgery could shorten the surgical, ICU, hospitalization, and thoracic tube drainage times, as well as reduce the amount of intraoperative bleeding and the incidence of postoperative complications. However, no significant differences were observed between the procedures in terms of the tumor recurrence rate.…”

Section: Discussionmentioning

confidence: 87%

“…A total of 919 relevant documents were obtained in the preliminary search, including eight cohort studies, with a total of 1,093 patients (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The CNKI, PubMed and Metetron databases were systematically searched from January 2010 to October 2021.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

“…There were some limitations in this study that should be noted. Firstly, only five RCTs (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) were included, all of which were Chinese studies. Therefore, a high risk of bias exists.…”

Section: Discussionmentioning

confidence: 99%

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Comparing the safety and efficacy of thoracoscopic surgery and thoracotomy for thymoma: a systematic review and meta-analysis

Lv¹,

Li²,

Men³

et al. 2021

Gland Surg

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Background: To systematically evaluate the efficacy of thoracoscopic surgery compared to traditional thoracotomy for thymic tumors. Methods:We performed a literature search on computer of the PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine (CBM), WanFang, and China national knowledge infrastructure (CNKI) databases from the date of establishment of the database to April 2021, and retrieved randomized controlled trials (RCTs) and cohort studies on thoracoscopic surgery and thoracotomy with conventional open thoracic surgery. After independent screening of the literature by two assessors, the relevant data was extracted and the risk of bias in the included studies was evaluated. RevMan 5.3 software was used to perform the analysis.Results: Five RCTs and eight cohort studies were ultimately included, with a total of 1,093 patients. The results of meta-analysis showed that compared with traditional thoracoscopic surgery, thoracoscopy had

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Section: Discussionmentioning

confidence: 87%

Section: Results Of the Literature Searchmentioning

confidence: 99%

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Comparing the safety and efficacy of thoracoscopic surgery and thoracotomy for thymoma: a systematic review and meta-analysis

Lv¹,

Li²,

Men³

et al. 2021

Gland Surg

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“…Because of this, surgical resection has been an important component of treatment ( 8 ). Ma et al report upfront surgical resection was associated with better overall survival in patients with thymic carcinoma than those who underwent neoadjuvant radiation followed by delayed surgery ( 10 ). Interestingly, this survival benefit was not seen in patients with thymomas.…”

Section: Stage Iva Tet: Considerations and Heterogeneitymentioning

confidence: 99%

The role of surgery in the management of locally advanced and metastatic thymoma: a narrative review

Wagner¹,

Wakeam²,

Keshavjee³

2021

Mediastinum

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Thymic epithelial tumors (TETs) are rare neoplasms. While treatment guidelines for early stage TETs are well established, treatment for advanced and locally invasive and metastatic TETs (Masaoka stage IVa/IVb) is varied. Many studies examining outcomes in this patient population are single institution, retrospective studies with small sample sizes. Further complicating study of advanced TETs is that Masaoka stage IVa/IVb describes a wide variety of disease heterogeneity, and includes both thymoma and thymic carcinoma. Thus, recommendations for treatment strategies vary widely. Surgical resection with an R0 resection is a key component of treatment for early stage TETs, however the utility of surgery and appropriate surgical approach for patients with locally invasive disease is debated and ranges from local metastasectomy to extrapleural pneumonectomy (EPP). The use of multimodal therapies, including adjuvant and neoadjuvant radiation and chemoradiation, are important for patients with locally advanced disease, however identifying patients who would most benefit from each strategy has been challenging. In this review we examined the literature to provide treatment strategies for advanced TETs. Surgery with an R0 resection should be attempted in all risk appropriate patients. Multimodal therapies are likely beneficial to patients particularly with locally advanced disease, and neoadjuvant therapies may increase likelihood of R0 resection. Further investigation is necessary to identify optimal treatment strategies for patients with locally advanced TETs.

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“…We found that up-front surgery led to the best OS, and patients with advanced thymic cancer usually received induction chemotherapy with or without further surgery. 17 Due to the rarity of thymic cancer, few studies have directly compared patients' outcomes according to different front-line chemotherapies. With the exception of the pathological subtype of TC and advanced-stage tumors without complete resection, adverse prognostic factors have rarely been discussed.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes for patients with thymoma and thymic carcinoma after undergoing different front‐line chemotherapy regimens

Lin

Hsu

et al. 2022

Cancer Medicine

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Background Front‐line platinum‐base chemotherapy for advanced thymoma and thymic carcinoma (TC) improves resectability and prolongs patients' overall survival (OS). In this study, we evaluated patients' outcomes given different front‐line regimens: cisplatin, doxorubicin, and cyclophosphamide (CAP); cisplatin and etoposide (EP); or cisplatin and paclitaxel (TP). Materials and Methods We retrospectively evaluated the medical records of patients with advanced thymoma and TC who were treated at our medical center between 2005 and 2015. We investigated objective response rates (ORRs), progression‐free survival (PFS), and OS after undergoing different front‐line regimens. Results Among the 108 enrolled patients, 37 (34%) had thymoma and 71 (66%) had TC; 45 received CAP, 36 received EP, and 27 received TP regimens. The ORRs of patients receiving CAP, EP, and TP were 51%, 50%, and 41%, respectively. For patients with stage III and IVA disease, the median PFS after CAP, EP, and TP were 34.5, 26.4, and 18.0 months (p = 0.424), respectively, and the 5‐year OS rates were 84.9%, 70.6%, and 60.0% (p = 0.509). In patients with stage IVB disease, the median PFS were 9.4, 8.2, and 11.6 months after undergoing CAP, EP, and TP (p = 0.173), respectively, and the 5‐year OS rates were 41.1%, 39.1%, and 14.3% (p = 0.788). TC pathology subtype and liver metastasis were associated with poor OS. Three patients with stage IVB TC had an OS of more than 5 years. Conclusion Different front‐line chemotherapy regimens may provide similar long‐term PFS and OS in patients with advanced thymoma and TC. In addition to TC and liver metastasis were associated with poor OS, other potential prognostic factors are warranted for studying.

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Clinical Outcomes of Up-front Surgery Versus Surgery After Induction Chemotherapy for Thymoma and Thymic Carcinoma: A Retrospective Study

Cited by 11 publications

References 28 publications

Comparing the safety and efficacy of thoracoscopic surgery and thoracotomy for thymoma: a systematic review and meta-analysis

Comparing the safety and efficacy of thoracoscopic surgery and thoracotomy for thymoma: a systematic review and meta-analysis

The role of surgery in the management of locally advanced and metastatic thymoma: a narrative review

Clinical outcomes for patients with thymoma and thymic carcinoma after undergoing different front‐line chemotherapy regimens

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