Surgical feasibility and long‐term outcome of superior vena cava replacement for advanced thymoma in patients undergoing preoperative chemotherapy or chemoradiotherapy

Yu, Zhen; Yu, Lei; Yu, Tao; Yang, Xingguo; Zhang, Bao-Xun; Du, Xin

doi:10.1111/1759-7714.13872

Cited by 7 publications

(10 citation statements)

References 32 publications

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“…Comacchio et al 19 reported a favourable outcome in 144 vascular resections for thymomas (five- and 10-years OS rates of 75% and 56%, respectively), with a worse DFS in case of pathological vascular infiltration (49% and 41%, respectively). Similarly, a retrospective analysis performed by Yu et al 20 reported a five- and 10-year OS of 93.94%, and 60.81% in a series of 45 patients undergoing vascular resection/reconstruction. Compared to NSCLC patients, RTCs outcome reflects the specific tumour biology as well as global patients’ features: younger age, less risk factors (smoking) and/or comorbidities (emphysema, coronary disease).…”

Section: Discussionsupporting

confidence: 91%

Long term outcome of complex surgical resection and reconstruction for rare thoracic cancers

Pastorino

Leuzzi

Sabia

et al. 2023

Tumori

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Background Complex surgical resection and reconstruction for rare thoracic cancers (RTCs) represent a major challenge, given their very low frequency, extreme variability of presentation, multi-modality treatment options and inadequate outcome prediction. We analysed the experience of a tertiary referral centre on a consecutive series of patients with thoracic germ cell tumours, thymomas and sarcomas, with the aim of reporting the long-term outcome by cancer type and complexity of surgical procedures. Methods From Jan 2003 to Dec 2018, 768 surgical procedures were performed with curative intent on 644 RTC patients. Study endpoints were: post-operative hospital stay (Pod), 30-day and 90-day mortality, 5-year and 10-year overall survival (OS). Median follow-up of alive patients was 7.2 years. Results Median Pod was 7 days, with a 1.2% 30-day and 2.9% 90-day mortality. OS was 90.8% at one year, 74.2% at five years and 62.8% at 10 years. Ten-year OS was 73.0% in low, 65.3% in intermediate, and 55.6% in high complexity score (Log-rank tests p<0.0001); 66.6% in patients with one or two reconstructions and 46.4% in patients with three or more reconstructions (p<0.0001); 46.0% with vascular and 50.0% with chest wall reconstruction; 71.8% in germ cell tumours, 64.6% in thymoma and 51.3% in sarcoma (p<0.0001). Conclusion Complex surgical resection and reconstruction was associated with acceptable 90-day mortality and good 10-year survival in all RTC types. A predictive score based on surgical complexity and cancer type can help the clinical decision making.

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Section: Discussionsupporting

confidence: 91%

Long term outcome of complex surgical resection and reconstruction for rare thoracic cancers

Pastorino

Leuzzi

Sabia

et al. 2023

Tumori

View full text Add to dashboard Cite

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“…Comacchio et al reported a favourable outcome in 144 vascular resections for thymomas (5- and 10-years OS rates of 75% and 56%, respectively), with a worse DFS in case of pathological vascular infiltration (49% and 41%, respectively) [26]. Similarly, a retrospective analysis performed by Yu Z et al [27] reported a 5- and 10-year OS of 93.94%, and 60.81% in a series of 45 patients undergoing vascular resection/reconstruction. Compared to NSCLC patients, RTCs outcome reflects the specific tumour biology as well as global patients’ features: younger age, less risk factors (smoking) and/or comorbidities (emphysema, coronary disease).…”

Section: Discussionmentioning

confidence: 99%

Outcome of complex surgical resection and reconstruction for rare thoracic cancers: the clinical value of a predictive score

Pastorino

Leuzzi

Sabia

et al. 2022

Preprint

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BackgroundComplex surgical resection and reconstruction for rare thoracic cancers (RTCs) represent a major challenge, given their very low frequency, extreme variability of presentation, multi-modality treatment options and inadequate outcome prediction. We reported the experience of a tertiary referral centre on a consecutive series of RTC patients, to predict outcome by disease and complexity of surgical procedures.MethodsFrom Jan 2003 to Dec 2018, 1122 surgical procedures were performed with curative intent on 952 RTC patients. Study endpoints were: post-operative hospital stay (Pod), 30-day and 90-day mortality, 5-year and 10-year survival (OS). The follow-up was closed at June 2020.ResultsMedian Pod was 8 days, with a 2% 30-day and 3.9% 90-day mortality. Overall survival (OS) was 85.7% at 1 year, 61.7% at 5 years and 50.7% at 10 years. Ten-year OS was 64.8% in low, 58.8% in intermediate, and 42.4% in high complexity score (Log-rank tests p<0.0001); 64.4% in patients with 1 or 2 reconstructions and 32.8% in patients with 3 or more reconstructions; 44.5% with vascular and 48% with chest wall reconstruction; 71.8% in germ cell tumors and 0% in mesothelioma.ConclusionComplex surgical resection and reconstruction was associated with acceptable 90-day mortality and good 10-year survival in all RTCs but mesothelioma.A predictive score based on surgical complexity and cancer type can help the clinical decision making.

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“…Previous reports of locally advanced TETs since 2000 are shown in Table 2 , though some cases included Masaoka stage IVb. Previous studies reported significant variations in the rates of complete resection following induction therapy for locally advanced TETs, ranging from 15% to 95% ( 18 - 25 , 33 , 34 , 37 - 44 ). This wide range of outcomes was likely due to the heterogeneous nature of locally advanced TETs.…”

Section: Combined Resection Of Surrounding Organs and R0 Resectionmentioning

confidence: 99%

Perioperative management and postoperative outcomes of locally advanced thymic epithelial tumors: a narrative review

Takenaka,

Kuroda,

Tanaka

2024

Mediastinum

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Background and Objective Thymic epithelial tumors (TETs) are frequently diagnosed at an advanced stage, highlighting the importance of understanding the treatment strategies for these cases. Surgical intervention after chemotherapy or chemoradiotherapy presents specific challenges and underscores the crucial role of perioperative management. This study aimed to explore the perioperative management and postoperative outcomes in patients with locally advanced TETs. Methods Relevant studies published between 2000 and 2022 were identified through PubMed searches using a combination of the following terms: “Locally advanced TETs”, “Thymoma”, “Thymic cancer”, “Surgery”, “Induction therapy”, and “Postoperative outcomes”. We analyzed available data to describe the perioperative management and postoperative outcomes of locally advanced TETs. Key Content and Findings Surgical outcomes after induction therapy for locally advanced TETs were analyzed for 18 references (total n=646) between 2000 and 2022. The primary objective of induction therapy for locally advanced TETs is complete tumor resection. In recent years, many medical centers have adopted systemic chemotherapy and chemoradiation for the treatment of thymoma and thymic carcinoma, respectively. During surgical intervention, resecting the surrounding organs, such as the lungs, pericardium, and phrenic nerves, is a common practice. Additionally, there may be cases wherein vascular resection of the superior vena cava (SVC) and innominate veins is necessary. Techniques and strategies for revascularization without complications are crucial in these situations. The incidence of postoperative complications varied significantly, ranging from 4.8% to 42%. However, perioperative mortality is typically reported to be approximately 0%, with only two reports showing mortality rates of 1.8% and 9.0%. Conclusions The short-term postoperative outcomes of surgical treatment following induction therapy for locally advanced TETs were generally deemed acceptable. However, incomplete resection may occur, particularly when the tumor invades the pulmonary artery or aorta. Hence, careful evaluation the indications for surgery is crucial, considering the patient’s overall condition and treatment response.

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Surgical feasibility and long‐term outcome of superior vena cava replacement for advanced thymoma in patients undergoing preoperative chemotherapy or chemoradiotherapy

Cited by 7 publications

References 32 publications

Long term outcome of complex surgical resection and reconstruction for rare thoracic cancers

Long term outcome of complex surgical resection and reconstruction for rare thoracic cancers

Outcome of complex surgical resection and reconstruction for rare thoracic cancers: the clinical value of a predictive score

Perioperative management and postoperative outcomes of locally advanced thymic epithelial tumors: a narrative review

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