Abstract | BACKGROUND: The optimal treatment method for thymoma with pleural dissemination remains controversial. We analyzed our experience with a multimodality approach and evaluated the role of extrapleural pneumonectomy (EPP) in the treatment of disseminated thymoma. METHODS: RESULTS: Eight patients underwent induction chemotherapy. The response rate to CAMP was 85%. Thymectomy with or without the resection of disseminated pleural tumors was performed in 7 patients and EPP in 3. Postoperative radiotherapy was administered in 6. All patients except 1 with EPP had recurrence: pleural recurrence in 7, lung in 1, and multiple organs in 2. Nine patients were retreated with chemotherapy, radiotherapy, pulmonary metastasectomy, or pleurectomy. One underwent EPP for pleural recurrence. Consequently, among the 7 patients without EPP, only 1 was alive without disease and 4 were alive with pleural recurrence. In contrast, 3 of the 4 patients with EPP had no local failure and were alive without recurrence. CONCLUSIONS: In multimodality therapy for thymoma with pleural dissemination, EPP offers good local control and may lead to cure.
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Authors | Yoshinori Ishikawa, Haruhisa Matsuguma, Rie Nakahara, Haruko Suzuki, Akiko Ui, Tetsuro Kondo, Yukari Kamiyama, Seiji Igarashi, Kiyoshi Mori, Tetsuro Kodama, Kohei Yokoi |
Journal | The Annals of thoracic surgery
(Ann Thorac Surg)
Vol. 88
Issue 3
Pg. 952-7
(Sep 2009)
ISSN: 1552-6259 [Electronic] Netherlands |
PMID | 19699926
(Publication Type: Journal Article)
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Topics |
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Carcinoma, Squamous Cell
(mortality, pathology, secondary, surgery)
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Disease-Free Survival
- Female
- Follow-Up Studies
- Humans
- Lymphatic Metastasis
(pathology)
- Male
- Middle Aged
- Neoadjuvant Therapy
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local
(drug therapy, mortality, pathology, surgery)
- Neoplasm Staging
- Pleura
(pathology)
- Pleural Neoplasms
(mortality, pathology, secondary)
- Pneumonectomy
(methods)
- Prognosis
- Radiotherapy Dosage
- Radiotherapy, Adjuvant
- Thymectomy
(methods)
- Thymoma
(mortality, pathology, secondary, surgery)
- Thymus Neoplasms
(mortality, pathology, surgery)
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