Surgical cytoreduction and hyperthermic intrathoracic chemotherapy for thymic tumours with pleural spread is effective on survival: results from the multicentre German hyperthermic intrathoracic chemotherapy study

Ried, Michael and Hassan, Mohamed and Passlick, Bernward and Schmid, Severin and Markowiak, Till and Mueller, Karolina and Huppertz, Gunnar and Koller, Michael and Winter, Hauke and Klotz, Laura and Hatz, Rudolf and Kovacs, Julia and Zimmermann, Julia and Hofmann, Hans-Stefan and Eichhorn, Martin E. (2023) Surgical cytoreduction and hyperthermic intrathoracic chemotherapy for thymic tumours with pleural spread is effective on survival: results from the multicentre German hyperthermic intrathoracic chemotherapy study. INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY, 36 (6): ivad032. ISSN , 2753-670X

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Abstract

OBJECTIVES: Cytoreductive surgery and hyperthermic intrathoracic chemotherapy (HITOC) is effective on survival for patients with pleural metastatic thymic tumours.METHODS: Multicentre, retrospective analysis of patients with stage IVa thymic tumours treated with surgical resection and HITOC. Primary end point was overall survival, secondary end points were recurrence-/progression-free survival and morbidity/mortality.RESULTS: A total of n = 58 patients (thymoma, n = 42; thymic carcinoma, n = 15; atypical carcinoid of the thymus, n = 1) were included, who had primary pleural metastases (n = 50; 86%) or pleural recurrence (n = 8; 14%). Lung-preserving resection (n = 56; 97%) was the preferred approach. Macroscopically complete tumour resection was achieved in n = 49 patients (85%). HITOC was performed with cisplatin alone (n = 38; 66%) or in combination with doxorubicin (n = 20; 34%). Almost half of the patients (n = 28; 48%) received high-dose cisplatin > 125 mg/m(2) body surface area. Surgical revision was required in 8 (14%) patients. In-hospital mortality rate was 2%. During follow-up, tumour recurrence/progression was evident in n = 31 (53%) patients. Median follow-up time was 59 months. The 1-, 3- and 5-year survival rates were 95%, 83% and 77%, respectively. Recurrence/progression-free survival rates were 89%, 54% and 44%, respectively. Patients with thymoma had significantly better survival compared to patients with thymic carcinoma (P-value =0.001).CONCLUSIONS: Promising survival rates in patients with pleural metastatic stage IVa in thymoma (94%) and even in thymic carcinoma (41%) were achieved. Surgical resection and HITOC is safe and effective for treatment of patients with pleural metastatic thymic tumours stage IVa.

Item Type: Article
Uncontrolled Keywords: CLASSIFICATION; PERFUSION; RESECTION; SURGERY; THYMOMA; MALIGNANCIES; MANAGEMENT; PROPOSAL; Hyperthermic intrathoracic chemotherapy; Thymic tumour; Thymic carcinoma; Cytoreductive surgery
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Abteilung für Thoraxchirurgie
Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien
Depositing User: Dr. Gernot Deinzer
Date Deposited: 10 Mar 2024 14:42
Last Modified: 10 Mar 2024 14:42
URI: https://pred.uni-regensburg.de/id/eprint/59608

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