Thymic Carcinoma: Outcomes After Surgical Resection

Okereke, Ikenna; Kesler, Kenneth A.; Freeman, Richard K.; Rieger, Karen M.; Birdas, Thomas J.; Ascioti, Anthony J.; Badve, Sunil; Nelson, Robert P.; Loehrer, Patrick J.

doi:10.1016/j.athoracsur.2012.01.014

Cited by 58 publications

(46 citation statements)

References 23 publications

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“…After a complete surgical resection, the utility of radiation therapy has been debated in the literature and was reported to have no effect on the global survival or the survival without progression [5,22,56,58]. For low grade tumors, some authors reported the role of radiation therapy following surgical resection in the decrease of loco regional recurrences and secondary localizations [6,9,28,36,54,61,62,66,80,92].…”

Section: Discussionmentioning

confidence: 99%

“…Adjuvant chemotherapy or radiation therapy have been also reported as a good prognostic factor related to the global survival and the survival without progression. [6,9,28,36,54,61,62,66,80].…”

Section: Discussionmentioning

confidence: 99%

“…In a second time, when the diagnosis of thymoma is excluded, the diagnosis of a mediastinal metastasis has to be ruled out. The advantage of this treatment is refl ected by the improvement of the global survival, the survival without recurrence and without metastases [29,36]. A second line chemotherapy was used in 2 studies according to the protocols ABVD (Adriamycin + Delicum + Bleomycin + Velbemycin).…”

Section: Discussionmentioning

confidence: 99%

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Review of the literature about Thymic Carcinomas

Mlika¹,

Mezni²

2017

Arch Pulmonol Respir Care

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Background: Thymic carcinomas (TC) are rare tumors with challenging diagnosis and management. We aimed to describe the clinical and microscopic characteristics of TC through a literature review.Results: 82 articles and abstracts were retained about 2913 TC. Our study contained 1760 men and 1153 women with a mean age of 55.32 years. The delay of diagnosis was specifi ed in 10 cases and varied between 8 months and 2 years. Symptoms consisted mainly in chest pain and dyspnea. The Computed Tomography-scan (CT-scan) fi ndings were specifi ed in 63 cases. Microscopic fi ndings were noticed in 1766 cases. They consisted mainly in squamous cell carcinoma in 1297 cases and undifferentiated carcinoma in 239 cases. The patients presented stage 1 tumors in 165 cases, stage II in 362 cases, stage III in 1011 cases and stage IV in 1166 cases. The treatment modalities were noticed in 2803 cases. There was no consensus of the regimen of chemotherapy or the place of the radiation therapy but all studies highlighted the key role of the complete surgical resection when possible. Conclusion:Our results highlight the lack of consensual management of TC. The chemotherapy regimen, the second-line chemotherapy and the indications of radiation therapy seem non-consensual and need further studies. Many interrogations remain concerning the management of these tumors according to their histologic grade. The real place of targeted therapy remains to assess and the rare opinions published are based on rare and non-representative cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Review of the literature about Thymic Carcinomas

Mlika¹,

Mezni²

2017

Arch Pulmonol Respir Care

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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

“…8 El tratamiento quirúrgico utilizado es la esternotomía media 34 aunque también se puede realizar toracotomía anterolateral. 27,30,35 La radioterapia ayuda al control local de la enfermedad. 30 Su uso en pacientes con carcinoma tímico Masaoka II es motivo de controversia ya que los tumores con infiltración transcapsular pueden tratarse solamente con cirugía.…”

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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American Radium Society Appropriate Use Criteria for Radiation Therapy in the Multidisciplinary Management of Thymic Carcinoma

et al. 2023

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ImportanceThymic carcinoma is rare, and its oncologic management is controversial due to a paucity of prospective data. For this reason, multidisciplinary consensus guidelines are crucial to guide oncologic management.ObjectiveTo develop expert multidisciplinary consensus guidelines on the management of common presentations of thymic carcinoma.Evidence ReviewCase variants spanning the spectrum of stage I to IV thymic carcinoma were developed by the 15-member multidisciplinary American Radium Society (ARS) Thoracic Appropriate Use Criteria (AUC) expert panel to address management controversies. A comprehensive review of the English-language medical literature from 1980 to 2021 was performed to inform consensus guidelines. Variants and procedures were evaluated by the panel using modified Delphi methodology. Agreement/consensus was defined as less than or equal to 3 rating points from median. Consensus recommendations were then approved by the ARS Executive Committee and subject to public comment per established ARS procedures.FindingsThe ARS Thoracic AUC panel identified 89 relevant references and obtained consensus for all procedures evaluated for thymic carcinoma. Minimally invasive thymectomy was rated as usually inappropriate (regardless of stage) due to the infiltrative nature of thymic carcinomas. There was consensus that conventionally fractionated radiation (1.8-2 Gy daily) to a dose of 45 to 60 Gy adjuvantly and 60 to 66 Gy in the definitive setting is appropriate and that elective nodal irradiation is inappropriate. For radiation technique, the panel recommended use of intensity-modulated radiation therapy or proton therapy (rather than 3-dimensional conformal radiotherapy) to reduce radiation exposure to the heart and lungs.Conclusions and RelevanceThe ARS Thoracic AUC panel has developed multidisciplinary consensus guidelines for various presentations of thymic carcinoma, perhaps the most well referenced on the topic.

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Thymic Carcinoma: Outcomes After Surgical Resection

Cited by 58 publications

References 23 publications

Review of the literature about Thymic Carcinomas

Review of the literature about Thymic Carcinomas

Carcinoma tímico en niños. Informe de dos casos

American Radium Society Appropriate Use Criteria for Radiation Therapy in the Multidisciplinary Management of Thymic Carcinoma

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