Long-term outcome after multimodality treatment for stage III thymic tumors

Venuta, Federico; Rendina, Erino Angelo; Longo, Flavia; Giacomo, Tiziano De; Anile, Marco; Mercadante, Edoardo; Ventura, Luigi; Osti, Mattia Falchetto; Francioni, Federico; Coloni, Giorgio F.

doi:10.1016/s0003-4975(03)01020-8

Cited by 185 publications

(167 citation statements)

References 38 publications

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“…Recently, Shin et al (1998) reported that 82% of 12 unresectable TETs were completely resected after induction chemotherapy, and another study (Venuta et al, 2003) reported an increased resection rate and prolonged survival for stage III and IV TETs following neoadjuvant chemotherapy with cisplatin, epirubicin, and etoposide compared to the historical control. In multivariate analysis, the tumour stage and WHO histotype were two independent factors for predicting overall survival (Po0.001, Po0.001, respectively).…”

Section: Discussionmentioning

confidence: 99%

A single institutional experience of thymic epithelial tumours over 11 years: clinical features and outcome and implications for future management

et al. 2007

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Thymic epithelial tumours (TETs), the most common tumour of the anterior mediastinum, are epithelial neoplasms of the thymus with a wide spectrum of morphologic features. We retrospectively analysed clinical features of TET and the correlation of World Health Organisation (WHO) histologic classification and Masaoka staging system with different treatment modalities in 195 patients, from 1995 to 2005. According to the Masaoka's staging system, there were 78 (40.0 %) patients with stage I, 38 (19.5%) with stage II, 41 (21.0%) with stage III, 38 (19.5%) with stage IV. All patients were reclassified according to the WHO criteria as follows: Type A (n ¼ 9, 4.6%), AB (n ¼ 37, 18.9%), B1 (n ¼ 29, 14.8%), B2 (n ¼ 48, 24.6%), B3 (n ¼ 40, 20.5%), C (n ¼ 32, 16.4%). There was a fairly good correlation between Masaoka staging and WHO histotype (Po0.05). However, in multivariate analysis, the tumour stage and WHO histotype were two independent factors separately for predicting overall survival (Po0.001, Po0.001, respectively). Thus, both Masaoka stage and WHO histotype should be considered in risk stratification of therapy for TET patients. Patients with completely resected types B2, B3 and C and adjuvant radiotherapy (n ¼ 57) had more favourable disease-free and overall survival as compared with those without adjuvant treatment (n ¼ 20) (P ¼ 0.015, 0.015, respectively). Given that the predominant sites of recurrence after surgery was pleura/pericardium and lung, and the fact that complete resection was a significant influential factor for survival at log -rank test, an active investigation of newer treatment strategies such as neoadjuvant treatment to improve the resectability and development of optimal adjuvant treatment modality is a high priority especially for those with high-risk for recurrence or in patients with advanced stage disease.

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Section: Discussionmentioning

confidence: 99%

A single institutional experience of thymic epithelial tumours over 11 years: clinical features and outcome and implications for future management

et al. 2007

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“…Several chemotherapy regimens have been used in this setting, mostly consisting of adriamycin-and/or platin-based multi-agent combinations (table 4, fig. 2) [78][79][80][81][82][83][84][85][86][87][88]. Usually two to four cycles of chemotherapy are administered before imaging reassessment.…”

Section: Chemotherapy Principlesmentioning

confidence: 99%

Thymic epithelial tumours: from basic principles to individualised treatment strategies

Girard¹

2013

European Respiratory Review

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Thymic epithelial tumours represent a wide range of anatomical, clinical, histological and molecular malignant entities that may be aggressive and difficult to treat. The histopathological classification distinguishes thymomas from thymic carcinomas. Thymomas may be associated with autoimmune disorders.The management of thymic epithelial tumours is a paradigm of co-operation between clinicians, surgeons and pathologists, from establishing the diagnosis to organising the multimodal therapeutic strategy. Surgery is the mainstay of the curative-intent treatment, as complete resection represents the most significantly favourable prognostic factor on overall survival. In case of invasion of intra-thoracic structures and/or dissemination to the pleura and the pericardium, precluding complete resection to be achieved, primary chemotherapy has been used to reduce the tumour burden, possibly allowing subsequent surgery and/or radiotherapy.Novel strategies are needed, especially for refractory, recurrent tumours and thymic carcinomas, which carry a poor prognosis. Personalised approaches are currently being developed, as potentially ''druggable'' molecular targets are emerging from recent integrated genomic analyses. Along with the large variety of questions relative to the treatment strategy, thymic epithelial tumours represent a model of therapeutic implementation and achievement in orphan thoracic oncology, showing how the advent of new results induces new questions, as well as diversifies further clinical research directions and international collaborative initiatives.

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“…26 La resección tumoral completa ofrece las mejores oportunidades de curación. 3,[25][26][27][28][29] Los pacientes con tumores en estadio I tratados solamente con resección completa tienen supervivencia a 5 años de 100%, con recurrencia de 1%. 26,[30][31][32] La resección subtotal es insuficiente; sólo un tercio de los pacientes a quienes se les realizó biopsia inicialmente viven 10 años.…”

Section: Introductionunclassified

“…40 La quimioterapia neoadyuvante está indicada cuando la resección completa no es posible y se quiere reducir el tamaño tumoral y la extensión de la infiltración. 39,41,46,47 Venuta y su equipo 28 observaron 90% de supervivencia en pacientes que recibieron quimioterapia de inducción comparada con 71% en pacientes con escisión primaria.…”

Section: Introductionunclassified

Carcinoma tímico en niños. Informe de dos casos

et al. 2015

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Carcinoma tímico en niños. Informe de dos casosThymic carcinoma in pediatric population: report of two cases RESUMEN El carcinoma tímico es una neoplasia poco frecuente en la población pediátrica. El diagnóstico diferencial se realiza con tumores mediastinales. Generalmente las manifestaciones clínicas se deben a obstrucción de la vía aérea. El tratamiento incluye cirugía, quimioterapia y radioterapia. Los esquemas de tratamiento, especialmente la quimioterapia, es motivo de controversia en niños y la mayoría de los protocolos se basan en la experiencia obtenida de los adultos. El pronóstico es malo, con pocas posibilidades de curación, depende del estadio según la clasificación de Masaoka y de la posibilidad de resección quirúrgica.En este informe se describen dos casos de carcinoma tímico en niños: uno de 12 años cuya afección se inició con cianosis e hipercalcemia y en una paciente de 14 años en quien empezó con tos y dolor torácico. ABSTRACTThymic carcinoma is a rare tumor in pediatric population. Differential diagnoses include mediastinal tumors. Most clinical manifestations are due to obstruction. Treatment includes surgery, chemotherapy and radiotherapy. The treatment schemes, especially chemotherapy, are controversial in children, and most of them are based on the experience with adult patients. In general, thymic carcinoma has a poor prognosis, with low chances for cure, and it is based on Masaoka et al classification and the possibility of surgical resection.We report two cases of thymic carcinoma in children: a 12-year-old boy who presented with cyanosis and hypercalcemia, and a 14-year-old girl whose inicial symptoms were cough and chest pain.

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Long-term outcome after multimodality treatment for stage III thymic tumors

Cited by 185 publications

References 38 publications

A single institutional experience of thymic epithelial tumours over 11 years: clinical features and outcome and implications for future management

A single institutional experience of thymic epithelial tumours over 11 years: clinical features and outcome and implications for future management

Thymic epithelial tumours: from basic principles to individualised treatment strategies

Carcinoma tímico en niños. Informe de dos casos

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