Thymoma: Results with complete resection and adjuvant postoperative irradiation in 141 consecutive patients

Nakahara, Kazunari; Ohno, Kiyoshi; Hashimoto, Junpei; Maeda, Hitoshi; Miyoshi, Shinichiro; Sakurai, Masami; Monden, Yasumasa; Kawashima, Yasunaru

doi:10.1016/s0022-5223(19)35673-9

Cited by 222 publications

(77 citation statements)

References 19 publications

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“…The Masaoka stage was the independent prognostic factors for thymoma with 10-year survival rate were 99% in stage I, 94% in stage II, 88% in stage III, and 30% in stage IVa [23,24]. Our 50-year experience in germ cell tumors indicates the benign nature of mediastinal mature teratomas and excellent prognosis for seminomas after resection.…”

Section: Discussionmentioning

confidence: 68%

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Clinical spectrum of primary mediastinal tumors: A comparison of adult and pediatric populations at a single Japanese institution

Takeda

Miyoshi

Akashi

et al. 2003

Journal of Surgical Oncology

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119

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Section: Discussionmentioning

confidence: 68%

“…With improving chemotherapy and irradiation regimens, the operative results of mediastinal malignancies are improving. We also reported therapeutic strategies for each type of mediastinal tumor [23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Clinical spectrum of primary mediastinal tumors: A comparison of adult and pediatric populations at a single Japanese institution

Takeda

Miyoshi

Akashi

et al. 2003

Journal of Surgical Oncology

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119

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“…In contrast, the average 10-year survival rate in partially resected patients was 39%, approaching the 33% observed with biopsy alone [34]. There is at least some controversy here, because several reports show superior results with partial resection over biopsy [35][36][37][38].Tumor debulking, however, when compared with biopsy alone in a retrospective study, showed no better prognosis when followed by radiation therapy [39].…”

Section: Surgerymentioning

confidence: 95%

Thymoma: Benign Appearance, Malignant Potential

Riedel¹,

Burfeind

2006

The Oncologist

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Thymoma is a rare tumor with a largely indolent growth pattern. It does, however, have malignant potential as a result of its ability to invade locally and metastasize regionally. Often associated with a number of immuneand nonimmune-mediated paraneoplastic syndromes, patient outcomes are directly related to stage of disease and the ability to achieve a complete surgical resection. Surgery is the mainstay of treatment, with adjuvant radiation recommended for invasive thymoma. Sensitive to both chemotherapy and radiation, durable responses are achievable in incompletely resected and inoperable patients. We present two cases of thymoma followed by a general discussion with an emphasis on treatment for both early and advanced-stage disease. The Oncologist 2006;11:887-894 Case Presentation 1A 62-year-old woman, with no significant past medical history, presented to her primary care physician in November of 2005 for a routine physical exam. A chest x-ray was performed, in the absence of symptoms, which surprisingly revealed a right paramediastinal mass. Computed tomography (CT) scan of the chest revealed a 5.3-× 3.0-cm mass in the anterior mediastinum ( Fig. 1) with hypermetabolic activity by positron emission tomography (PET) scan. Fineneedle aspiration (FNA) performed at an outside hospital revealed a spindle-cell neoplasm consistent with thymoma. Routine laboratory studies were unrevealing, with the exception of quantitative immunoglobulins, which revealed decreased levels of IgA (68 mg/dl; normal range, 81-463), IgG (393 mg/dl; normal range, 694-1,618), and IgM (<5 mg/dl; normal range, 48-270). The patient was referred to the thoracic oncology program at our institution for evaluation and treatment. Case Presentation 2A 45-year-old Caucasian woman, with no significant past medical history, presented to an outside tertiary care facility in June of 2001 with complaints of slurred speech, difficulty swallowing, and blurry vision, and was diagnosed with myasthenia gravis. As part of the evaluation, imaging of the chest was performed, revealing a 10-cm right costophrenic mass with associated pleural-based lesions. The patient was referred to a thoracic surgeon who performed a thoracoscopic biopsy of a pleural-based mass, revealing lymphocyte-rich thymoma. She was deemed inoperable and received six cycles of cisplatin, doxorubicin, and cyclophosphamide (PAC) chemotherapy followed by radiation therapy. She had a durable response for 4.5 years and was followed with serial CT scans every 6 months. The most recent CT scan performed in December of 2005 revealed a right anterolateral pleural-based lesion (Fig. 2), which had increased in size from prior examination and was hypermetabolic by PET scan. An FNA was performed, revealing recurrent thymoma. The patient was referred to the thoracic oncology program at our institution for evaluation and treatment.

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“…Several authors reported favorable results of the reconstructions of the great veins using ringed PTFE graft replacement in patients with SVC syndrome caused by invasive thymoma. [2][3][4][5][6][7] However, few cases required partial resection of the RA. To our knowledge, our patient is the first case undergoing the reconstruction of the RA in addition to bilateral BC veins.…”

Section: (A) Ct Scan Showing a Large Mass In The Anterior Mediastinummentioning

confidence: 99%

“…Invasive thymomas are characterized by infiltrative growth and extension into the surrounding structures, 1 though intracaval growth causing the tumor to extend and directly invade the right atrium (RA) is rarely encountered. 2 Herein, we describe an unusual case of superior vena cava (SVC) syndrome due to an invasive thymoma, for which aggressive surgical treatment with an en bloc excision of the tumor with a partial lobectomy was performed, along with a combined resection of the SVC and the RA using a cardiopulmonary bypass (CPB).…”

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confidence: 99%

Radical Operation for Invasive Thymoma With Intracaval, Intracardiac, and Lung Invasion

et al. 2007

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We report a rare case of invasive type AB thymoma (WHO classification system) with intracaval and intracardiac extension into the right atrium. A cardiopulmonary bypass facilitated an en bloc excision of the tumor with a lobectomy, along with a combined resection of the right atrium and reconstruction of the bilateral brachiocephalic veins and right atrium. Aggressive surgical intervention should be considered in such cases, as long-term prognosis is primarily dependent on a complete resection of the extended thymoma.

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Thymoma: Results with complete resection and adjuvant postoperative irradiation in 141 consecutive patients

Cited by 222 publications

References 19 publications

Clinical spectrum of primary mediastinal tumors: A comparison of adult and pediatric populations at a single Japanese institution

Clinical spectrum of primary mediastinal tumors: A comparison of adult and pediatric populations at a single Japanese institution

Thymoma: Benign Appearance, Malignant Potential

Radical Operation for Invasive Thymoma With Intracaval, Intracardiac, and Lung Invasion

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