Verification of the diagnostic strategy for anterior mediastinal tumors
| Autor: | Kohei Yokoi, Koji Kawaguchi, Naoki Ozeki, Kumiko Hashimoto, Takayuki Fukui, Shota Nakamura, Masaki Goto, Toshinari Ito, Shunsuke Mori, Shuhei Hakiri |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Thymoma Adolescent Complete resection Mediastinal Neoplasms 03 medical and health sciences 0302 clinical medicine Surgical oncology medicine Biomarkers Tumor Humans Neoplasms Glandular and Epithelial Pathological Aged Retrospective Studies business.industry Tomography X-Ray Cancer Hematology General Medicine Guideline Thymus Neoplasms Middle Aged medicine.disease Diagnostic strategy Magnetic Resonance Imaging 030104 developmental biology Oncology 030220 oncology & carcinogenesis Radiological weapon Surgery Female Radiology business |
| Zdroj: | International journal of clinical oncology. 24(4) |
| ISSN: | 1437-7772 |
| Popis: | For thymic epithelial tumors (TETs), the National Comprehensive Cancer Network guideline has suggested that complete excision of the tumor should be performed without a preoperative biopsy when resectable. However, little evidence has been provided to support this strategy. The purpose of this study was to review our diagnostic process and to evaluate the validity of radical resection of anterior mediastinal masses (AMMs) without pathological confirmation. A total of 254 patients underwent surgical resection for AMMs between 2004 and 2015. This study included 181 patients with likely TETs according to clinical features, serum levels of tumor markers and autoimmune-antibodies, and radiological findings. In addition, AMMs likely TETs were classified into resectable or unresectable tumors. We retrospectively reviewed the diagnostic process of those patients and validated surgical resection of AMMs without a definitive diagnosis. Among 254 patients, 181 were suspected of having a TET based on the serum levels of tumor markers and autoimmune-antibodies and the radiological findings. Of them, 157 patients were deemed resectable and underwent surgical resection without histological confirmation, and 144 (92%) were diagnosed with TETs in the final pathological examinations. In 13 patients with non-TETs, the tumors were difficult to differentiate from TETs by imaging and clinical findings alone. A total of 92% of patients suspected of having a TET and who underwent complete resection without pathological confirmation were accurately diagnosed and properly treated. Surgical resection without a definitive diagnosis was feasible in patients suspected of having a TET when they were considered resectable. |
| Databáze: | OpenAIRE |
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