Multimodality therapy for thymoma patients with pleural dissemination

Autor: Takayuki Fukui, Kohei Yokoi, Toshinari Ito, Shota Nakamura, Masaki Goto, Koji Kawaguchi, Naoki Ozeki, Shuhei Hakiri, Shunsuke Mori, Kumiko Hashimoto
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Thymoma
Multimodality Therapy
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Lomustine
Antineoplastic Combined Chemotherapy Protocols
Myasthenia Gravis
medicine
Humans
Stage (cooking)
Pneumonectomy
Survival rate
Aged
Retrospective Studies
business.industry
Cytarabine
Induction chemotherapy
Thymic malignancy
Retrospective cohort study
Thymus Neoplasms
General Medicine
Middle Aged
Pleural Diseases
Multidisciplinary treatment
medicine.disease
Pleural dissemination
Combined Modality Therapy
Surgery
Cardiac surgery
Survival Rate
Cardiothoracic surgery
030220 oncology & carcinogenesis
Prednisone
Female
Mitoxantrone
Neoplasm Recurrence
Local
Cardiology and Cardiovascular Medicine
business
Zdroj: General Thoracic and Cardiovascular Surgery. 67(6):524-529
ISSN: 1863-6705
Popis: Background: Although multidisciplinary treatment is recommended for patients with advanced stage and recurrent thymoma, a detailed treatment strategy remains controversial. We have performed a multimodality therapy of induction chemotherapy (CAMP therapy: cisplatin, doxorubicin, and methylprednisolone) combined with surgery for those patients. We now conducted a retrospective study for investigating the results of this multimodality therapy for thymoma patients with pleural dissemination. Patients and methods: Between 2003 and 2017, 201 patients underwent surgical resection for thymomas. Twenty-six of them received induction CAMP therapy followed by surgery, and 19 of them with pleural dissemination were enrolled in this study. Those cohort were divided into 2 groups by employing surgical procedures: extrapleural pneumonectomy (EPP) group (n = 10) and resection of plural dissemination (RPD) group (n = 9). Results: The median age of all patients was 49 years. Based on the WHO classification, the histological diagnoses of those thymomas were as follows: Type B1 (n = 1), Type B2 (n = 13), and Type B3 (n = 5). Seven patients were complicated with myasthenia gravis (MG). Clinical stage of the 13 primary cases based on the Masaoka classification were stage IV, and the remaining six cases had recurrent pleural dissemination after surgery. Partial response in induction CAMP therapy was obtained in 78.9% (n = 15) of the patients. Adverse events (Grade 4) occurred in 2 patients (10.5%). Postoperative complications (Grade 4) were observed in 2 patients (10.5%). In all of the enrolled patients, the five-year overall survival rate (5Y-OS) and 5-year progression-free survival rate (5Y-PFS) were 76.7% and 55.1%, respectively. In the EPP group, 5Y-OS and 5Y-PFS were 83.3% and 83.3%, respectively, and in the RPD group, 70.0% and 29.6%, respectively. Conclusions: Multidisciplinary treatment using induction CAMP therapy and surgical resection for thymoma patients with pleural dissemination was effective and feasible. Because of the low recurrent rate of disease, young patients with good cardiopulmonary function and well-controlled MG might be good candidates for EPP.
ファイル公開：2020/06/01
Databáze: OpenAIRE
Externí odkaz: