Science and Research

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

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/m2 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.

  • Ried, M.
  • Hassan, M.
  • Passlick, B.
  • Schmid, S.
  • Markowiak, T.
  • Müller, K.
  • Huppertz, G.
  • Koller, M.
  • Winter, H.
  • Klotz, L. V.
  • Hatz, R.
  • Kovács, J.
  • Zimmermann, J.
  • Hofmann, H. S.
  • Eichhorn, M. E.

Keywords

  • Cytoreductive surgery
  • Hyperthermic intrathoracic chemotherapy
  • Thymic carcinoma
  • Thymic tumour
Publication details
DOI: 10.1093/icvts/ivad032
Journal: Interdiscip Cardiovasc Thorac Surg
Number: 6
Work Type: Original
Location: CPC-M, TLRC
Disease Area: LC
Partner / Member: ASK, Thorax
Access-Number: 37192006

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