Subtotal Pleurectomy with Intrathoracic Chemo Hyperthermia (HITHOC) for IVa Thymomas: De Novo Versus Recurrent Pleural Disease.

Autor: Chappuy B; Department of Thoracic Surgery, Lung and Heart-Lung Transplantation, University Hospital Louis Pradel, GH-Est, 69677 Lyon, France., Drevet G; Department of Thoracic Surgery, Lung and Heart-Lung Transplantation, University Hospital Louis Pradel, GH-Est, 69677 Lyon, France., Clermidy H; Department of Thoracic Surgery, Lung and Heart-Lung Transplantation, University Hospital Louis Pradel, GH-Est, 69677 Lyon, France., Rosamel P; Department of Anesthesiology and Critical Care Medicine, University Hospital Louis Pradel, GH-Est, 69677 Lyon, France., Duruisseaux M; Department of Thoracic Oncology, University Hospital Louis Pradel, GH-Est, 69677 Lyon, France.; Claude Bernard University Lyon 1 (UCBL1), 69677 Lyon, France., Couraud S; Claude Bernard University Lyon 1 (UCBL1), 69677 Lyon, France.; Department of Thoracic Oncology, University Hospital Lyon-Sud, GH-Sud, 69677 Lyon, France., Grima R; Department of Thoracic Surgery, Lung and Heart-Lung Transplantation, University Hospital Louis Pradel, GH-Est, 69677 Lyon, France., Soldea V; Department of Thoracic Surgery, Lung and Heart-Lung Transplantation, University Hospital Louis Pradel, GH-Est, 69677 Lyon, France., Chalabreysse L; Claude Bernard University Lyon 1 (UCBL1), 69677 Lyon, France.; Department of Pathology, University Hospital Louis Pradel, GH-Est, 69677 Lyon, France., Tronc F; Department of Thoracic Surgery, Lung and Heart-Lung Transplantation, University Hospital Louis Pradel, GH-Est, 69677 Lyon, France., Girard N; Department of Thoracic Oncology, Institut Curie, 75005 Paris, France.; RYTHMIC Network, Réseau Tumeurs Thymiques et Cancer, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805 Villejuif, France., Maury JM; Department of Thoracic Surgery, Lung and Heart-Lung Transplantation, University Hospital Louis Pradel, GH-Est, 69677 Lyon, France.; Claude Bernard University Lyon 1 (UCBL1), 69677 Lyon, France.; RYTHMIC Network, Réseau Tumeurs Thymiques et Cancer, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805 Villejuif, France.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2022 Oct 14; Vol. 14 (20). Date of Electronic Publication: 2022 Oct 14.
DOI: 10.3390/cancers14205035
Abstrakt: Introduction: Stage IVa thymoma is a rare disease without a standard of care. Subtotal pleurectomy and HITHOC introduced in highly selected patients may provide interesting oncologic results. The purpose of this study was to distinguish de novo stage IVa tumors (DNT) from distant relapse (DR) with respect to post-operative and long-term outcomes to provide the procedure efficacy.
Methods: From July 1997-December 2021, 40 patients with IVa pleural involvement were retrospectively analyzed. The surgical procedure was subtotal pleurectomy and HITHOC (cisplatin 50 mg/m 2 , mitomycin 25 mg/m 2 , 42 °C, 90 min). The post-operative outcome, disease-free interval (DFI) and overall survival (OS) were analyzed.
Results: Mean age was 52 ± 12 years. B2 and B3 thymomas were preponderant (27; 67.5%). The median number of pleural nodes were nine (4-81) vs. five (1-36); p = 0.004 * in DNT and DR, respectively. Hospital mortality rate was 2.5%. There were four specific HITHOC complications (10%). DFI were 49 and 85 months ( p = 0.02 *), OS were 94 and 118 months (NS), in DNT and DR, respectively.
Conclusions: Subtotal pleurectomy with HITHOC in IVa offers satisfying results in highly selected patients, for both DNT and DR. Due to the disease rarity, multicentric studies are needed to define HITHOC as a standard of care.
Databáze: MEDLINE
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