Induction Therapy Followed by Resection for Advanced Thymic Tumors

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  • Shintani Yasushi
    Department of General Thoracic Surgery, Osaka University Graduate School of Medicine
  • Kawamura Tomohiro
    Department of General Thoracic Surgery, Osaka University Graduate School of Medicine
  • Funaki Soichiro
    Department of General Thoracic Surgery, Osaka University Graduate School of Medicine
  • Minami Masato
    Department of General Thoracic Surgery, Osaka University Graduate School of Medicine
  • Inoue Masayoshi
    Department of General Thoracic Surgery, Kyoto Prefectural University of Medicine
  • Okumura Meinoshin
    Department of General Thoracic Surgery, Osaka University Graduate School of Medicine

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Other Title
  • 胸腺腫・胸腺癌に対する術前導入療法後の手術成績

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Description

Objective. We reviewed our institutional experience with cases of induction therapy followed by resection for advanced thymic tumors to determine patient outcomes and prognostic indicators. Method. The prognoses of 24 thymoma and 16 thymic cancer patients who underwent induction therapy followed by resection were retrospectively analyzed. The preoperative workup findings suggested great vessel invasion in 13 patients, mediastinal or intrathoracic lymph node metastasis in 3 patients and pleural dissemination in 11 patients. After the pathological diagnosis of the patient's biopsy specimens, they received induction therapy. There were 20, 13 and 7 patients with tumors that corresponded to Masaoka stages of III, IVa, and IVb, respectively. Results. The resection was extended to the surrounding organs in addition to thymectomy including the thymic tumor, such as the superior vena cava in 11 patients, the aorta in 1 patient, and the right brachiocephalic artery in 2 patients. Lobectomy was performed in 6 patients and pleuropneumonectomy was performed in 2 patients. There were no cases of operative mortality recorded among the patients who underwent induction therapy followed by surgery. Twenty-three patients had an R0 resection, 9 had an R1 resection and 8 had an R2 resection. The median follow-up period was 5.2 years. The 5-year survival rate for all patients was 82% (thymoma [93%], thymic cancer [63%], stage III [100%], stage IV [67%], R0 resection [100%], R1 resection [64%] and for R2 resection [60%]). There was no 5-year survivors among the thymic cancer patients who underwent an R1-R2 resection. Conclusion. A multimodal treatment strategy may result in a promising survival outcome for patients with advanced thymoma. Complete resection is the prognostic indicator in thymic cancer patients who undergo induction therapy followed by surgery.

Journal

  • Haigan

    Haigan 55 (6), 995-1000, 2015

    The Japan Lung Cancer Society

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