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Multimodality treatment for advanced thymic carcinoma: outcomes of induction therapy followed by surgical resection in 16 cases at a single institution

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Abstract

Objective

We reviewed our institutional experience with cases of multimodality treatment for advanced thymic carcinoma to determine patient outcomes and prognostic indicators.

Methods

Between 1998 and 2014, 16 patients with a Masaoka stage III or IV thymic carcinoma underwent surgical resection after induction therapy at Osaka University Hospital. These were considered to have great vessel invasion or metastasis to the mediastinal or intrathoracic lymph nodes based on the preoperative workup findings, and received induction therapy.

Results

Complete tumor resection was achieved in 11 (69 %) after the induction therapy. Pathological findings revealed that 10 patients had Masaoka stage III disease, 1 had IVa, and 5 had IVb. The histological diagnosis was squamous cell carcinoma in 13, neuroendocrine carcinoma in 2, and undifferentiated carcinoma in 1. The 5-year survival rate for all patients was 71 %. Survival was significantly better in patients who underwent a complete resection (R0 disease) as compared to those with incompletely resected tumors (R1 or R2 disease).

Conclusions

Multimodality treatment offers encouraging results and complete resection provides high survival rate for patients with advanced thymic carcinoma.

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References

  1. Okereke IC, Kesler KA, Freeman RK, Rieger KM, Birdas TJ, Ascioti AJ, Badve S, Nelson RP, Loehrer PJ. Thymic carcinoma: outcomes after surgical resection. Ann Thorac Surg. 2012;93:1668–72 (discussion 1672–1663).

    Article  PubMed  Google Scholar 

  2. Takeda S, Sawabata N, Inoue M, Koma M, Maeda H, Hirano H. Thymic carcinoma. Clinical institutional experience with 15 patients. Eur J Cardiothorac Surg. 2004;26:401–6.

    Article  PubMed  Google Scholar 

  3. Rea F, Marulli G, Di Chiara F, Schiavon M, Perissinotto E, Breda C, Favaretto AG, Calabrese F. Multidisciplinary approach for advanced stage thymic tumors: long-term outcome. Lung Cancer. 2011;72:68–72.

    Article  PubMed  Google Scholar 

  4. Wright CD, Choi NC, Wain JC, Mathisen DJ, Lynch TJ, Fidias P. Induction chemoradiotherapy followed by resection for locally advanced Masaoka stage III and IVA thymic tumors. Ann Thorac Surg. 2008;85:385–9.

    Article  PubMed  Google Scholar 

  5. Girard N. Thymic epithelial tumours: from basic principles to individualised treatment strategies. Eur Respir Rev. 2013;22:75–87.

    Article  PubMed  Google Scholar 

  6. Komaki R, Gomez DR. Radiotherapy for thymic carcinoma: adjuvant, inductive, and definitive. Front Oncol. 2014;3:330.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Korst RJ, Bezjak A, Blackmon S, Choi N, Fidias P, Liu G, Marx A, Wright C, Mock S, Rutledge JR, Keshavjee S. Neoadjuvant chemoradiotherapy for locally advanced thymic tumors: a phase II, multi-institutional clinical trial. J Thorac Cardiovasc Surg. 2014;147:36–44, 46 e31.

  8. Shintani Y, Ohta M, Hazama K, Miyoshi S, Kagisaki K, Matsuda H. Thymic carcinoma successfully resected with superior vena cava after chemoradiotherapy. Jpn J Thorac Cardiovasc Surg. 2001;49:717–21.

    Article  CAS  PubMed  Google Scholar 

  9. Ose N, Inoue M, Morii E, Shintani Y, Sawabata N, Okumura M. Multimodality therapy for large cell neuroendocrine carcinoma of the thymus. Ann Thorac Surg. 2013;96:e85–7.

    Article  PubMed  Google Scholar 

  10. Venuta F, Rendina EA, Longo F, De Giacomo T, Anile M, Mercadante E, Ventura L, Osti MF, Francioni F, Coloni GF. Long-term outcome after multimodality treatment for stage III thymic tumors. Ann Thorac Surg. 2003;76:1866–72 (discussion 1872).

    Article  PubMed  Google Scholar 

  11. Hernandez-Ilizaliturri FJ, Tan D, Cipolla D, Connolly G, Debb G, Ramnath N. Multimodality therapy for thymic carcinoma (TCA): results of a 30-year single-institution experience. Am J Clin Oncol. 2004;27:68–72.

    Article  CAS  PubMed  Google Scholar 

  12. Kondo K, Monden Y. Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan. Ann Thorac Surg. 2003;76:878–84 (discussion 884–875).

    Article  PubMed  Google Scholar 

  13. Tseng YL, Wang ST, Wu MH, Lin MY, Lai WW, Cheng FF. Thymic carcinoma: involvement of great vessels indicates poor prognosis. Ann Thorac Surg. 2003;76:1041–5.

    Article  PubMed  Google Scholar 

  14. Yano M, Sasaki H, Yokoyama T, Yukiue H, Kawano O, Suzuki S, Fujii Y. Thymic carcinoma: 30 cases at a single institution. J Thorac Oncol. 2008;3:265–9.

    Article  PubMed  Google Scholar 

  15. Attaran S, Acharya M, Punjabi PP, Anderson JR. Does surgical debulking for advanced stages of thymoma improve survival? Interact Cardiovasc Thorac Surg. 2012;15:494–7.

    Article  PubMed Central  PubMed  Google Scholar 

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Correspondence to Yasushi Shintani.

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Shintani, Y., Inoue, M., Kawamura, T. et al. Multimodality treatment for advanced thymic carcinoma: outcomes of induction therapy followed by surgical resection in 16 cases at a single institution. Gen Thorac Cardiovasc Surg 63, 159–163 (2015). https://doi.org/10.1007/s11748-014-0486-7

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  • DOI: https://doi.org/10.1007/s11748-014-0486-7

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