Multimodality Treatment of Thymoma: A Prospective Study

Venuta, Federico; Rendina, Erino Angelo; Pescarmona, Edoardo; Giacomo, Tiziano De; Vegna, M. L.; Fazi, Paola; Flaishman, Isac; Guarino, Enrico; Ricci, C.

doi:10.1016/s0003-4975(97)00629-2

Cited by 119 publications

(78 citation statements)

References 28 publications

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“…These findings are in sharp contrast to the suggested benign course for patients with these subtypes. 6,[12][13][14][15][16] Although our findings are subject to selection bias as patients with advanced/progressive disease are more likely to be referred for tertiary care, the study unequivocally shows the potential for aggressive behavior in these subtypes.…”

Section: Discussionmentioning

confidence: 91%

“…Although some promote and anticipate a benign clinical course for these tumors, 6,[12][13][14][15][16] others (ourselves included) consider all thymomas as potentially malignant neoplasms. [1][2]10,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Many prior studies have documented malignant behavior in types A and AB thymomas.…”

Section: Discussionmentioning

confidence: 99%

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WHO types A and AB thymomas: not always benign

Jain

Mehta

Henley³

et al. 2010

Modern Pathology

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The 2004 WHO classification of thymic tumors recognizes five major subtypes of thymomas and thymic carcinoma. Subtypes A and AB thymomas are purported to be benign neoplasms, although prior studies have suggested a potential for malignant behavior. The purpose of this study was to assess the clinical behavior of A and AB thymomas identified from a large institutional pathologic database. A retrospective slide review of 500 thymic epithelial tumors identified 71 (B14%) cases of types A and AB thymomas. Clinical history and follow-up information were obtained through retrospective chart review. There were 38 and 33 cases of types A and AB thymomas, respectively. Complete follow-up data were available in 37 (52%) cases. Eighteen (49%) patients (type A, n ¼ 9 and type AB, n ¼ 9) had evidence of recurrent/metastatic disease at an average of 62 months (range from 6 to 244 months) after initial diagnosis. Survival curves for patients with types A and AB thymomas, with and without recurrences, show a statistically significant difference (P ¼ 0.001 and 0.005, respectively). Analysis of this large cohort confirms the potential for subtypes A and AB thymomas to show malignant behavior. Long-term clinical monitoring, therefore, appears to be justified in these cases. This study also shows the poor correlation between the WHO classification and tumor behavior

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

WHO types A and AB thymomas: not always benign

Jain

Mehta

Henley³

et al. 2010

Modern Pathology

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“…Two of the complete resections showed no tumor on subsequent histologic exam. It has also been shown that multimodality treatment of patients with neoadjuvant chemotherapy, and surgery, followed by additional adjuvant chemotherapy plus radiotherapy, may improve the survival of patients with locally advanced thymoma [51]. In a case report by Yokoi and colleagues, a locally advanced thymoma invading the heart and great vessels was successfully treated with preoperative/postoperative cisplatin and doxorubicin, in addition to postoperative radiotherapy, with good results [52].…”

Section: Multimodality Therapymentioning

confidence: 99%

Thymoma: Update for the New Millenium

et al. 2001

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USA. Telephone: 210-616-5648; Fax: 210-949-5085; e-mail: cthomas@saci.org www: cancerdata.com Received October 11, 2000; accepted for publication May 11, 2001. ©AlphaMed Press 1083-7159/2001 INTRODUCTIONThymic tumors are common among anterior mediastinal tumors in adults. The vast majority of thymic lesions are thymoma [1]. Thymoma is relatively unique among tumors in that the prognosis appears to be more closely related to the invasive characteristics seen at operation rather than histological appearance. Indeed, the degree of encapsulation and invasion of adjacent tissues define malignancy for these tumors rather than the histologic appearance of the tumor cells [2]. Current treatment of thymoma is often multidisciplinary in nature, and has evolved based upon a growing number of studies to date. These studies have looked at various outcomes based upon associated patient syndromes, tumor histology, and tumor staging, as well as various surgical, radiotherapeutic, chemotherapeutic, and multimodality trials. These studies form the basis of this review.

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“…It is argued that this approach not only allows for more complete resection of the thymus gland including its upper poles but that it also lowers the risks of positive resection margins or capsular rupture. Direct tumor invasion into pericardium, phrenic nerves, pleura, lungs, superior vena cava, or innominate vein, which may have been overlooked pre-operatively, can also be dealt with understanding that doing a complete resection is the ultimate goal of surgery (10)(11)(12). Many experienced thoracic surgeons, including the senior author of this review, also argue that the operation done through a median sternotomy is well tolerated and does not cause much more postoperative pain and is not associated with longer lengths of stay than the same operation done through minimally invasive approaches.…”

Section: Controversies In Surgical Managementmentioning

confidence: 99%