Ried, Michael and Marx, Alexander and Gotz, Andrea and Hamer, Okka and Schalke, Berthold and Hofmann, Hans-Stefan (2016) State of the art: diagnostic tools and innovative therapies for treatment of advanced thymoma and thymic carcinoma. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 49 (6). pp. 1545-1552. ISSN 1010-7940, 1873-734X
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In this review article, state-of-the-art diagnostic tools and innovative treatments of thymoma and thymic carcinoma (TC) are described with special respect to advanced tumour stages. Complete surgical resection (R0) remains the standard therapeutic approach for almost all a priori resectable mediastinal tumours as defined by preoperative standard computed tomography (CT). If lymphoma or germ-cell tumours are differential diagnostic considerations, biopsy may be indicated. Resection status is the most important prognostic factor in thymoma and TC, followed by tumour stage. Advanced (Masaoka-Koga stage III and IVa) tumours require interdisciplinary therapy decisions based on distinctive findings of preoperative CT scan and ancillary investigations [magnetic resonance imaging (MRI)] to select cases for primary surgery or neoadjuvant strategies with optional secondary resection. In neoadjuvant settings, octreotide scans and histological evaluation of pretherapeutic needle biopsies may help to choose between somatostatin agonist/prednisolone regimens and neoadjuvant chemotherapy as first-line treatment. Finally, a multimodality treatment regime is recommended for advanced and unresectable thymic tumours. In conclusion, advanced stage thymoma and TC should preferably be treated in experienced centres in order to provide all modern diagnostic tools (imaging, histology) and innovative therapy techniques. Systemic and local (hyperthermic intrathoracic chemotherapy) medical treatments together with extended surgical resections have increased the therapeutic options in patients with advanced or recurrent thymoma and TC.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HYPERTHERMIC INTRATHORACIC CHEMOTHERAPY; HEALTH-ORGANIZATION CLASSIFICATION; MALIGNANT PLEURAL MESOTHELIOMA; SINGLE-INSTITUTION EXPERIENCE; MASAOKA STAGES III; STAGE-IVA THYMOMA; EPITHELIAL TUMORS; RADIATION-THERAPY; CYTOREDUCTIVE SURGERY; MULTIMODALITY THERAPY; Thymoma; Thymic carcinoma; Multimodality therapy; Hyperthermic intrathoracic chemotherapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Thoraxchirurgie Medicine > Lehrstuhl für Neurologie Medicine > Lehrstuhl für Strahlentherapie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 02 Sep 2020 06:18 |
| Last Modified: | 02 Sep 2020 06:18 |
| URI: | https://pred.uni-regensburg.de/id/eprint/2833 |
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