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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

Cytoreductive surgery and hyperthermic intrathoracic chemotherapy (HITOC) is effective on survival for patients with pleural metastatic thymic tumours.Multicentre, retrospective analysis of patients with stage IVa thymic tumours treated with surgical resection and HITOC. Primary end point was overal...

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Main Authors: Ried, Michael (Author) , Hassan, Mohamed (Author) , Passlick, Bernward (Author) , Schmid, Severin Thomas (Author) , Markowiak, Till (Author) , Müller, Karolina (Author) , Huppertz, Gunnar (Author) , Koller, Michael (Author) , Winter, Hauke (Author) , Klotz, Laura Valentina (Author) , Hatz, Rudolf (Author) , Kovács, Julia (Author) , Zimmermann, Julia (Author) , Hofmann, Hans-Stefan (Author) , Eichhorn, Martin E. (Author)
Format: Article (Journal)
Language:English
Published: 10 February 2023
In: Interdisciplinary cardiovascular and thoracic surgery
Year: 2023, Volume: 36, Issue: 6, Pages: 1-10
ISSN:2753-670X
DOI:10.1093/icvts/ivad032
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/icvts/ivad032
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Author Notes:Michael Ried, Mohamed Hassan, Bernward Passlick, Severin Schmid, Till Markowiak, Karolina Müller, Gunnar Huppertz, Michael Koller, Hauke Winter, Laura V. Klotz, Rudolf Hatz, Julia Kovács, Julia Zimmermann, Hans-Stefan Hofmann and Martin E. Eichhorn
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Summary:Cytoreductive surgery and hyperthermic intrathoracic chemotherapy (HITOC) is effective on survival for patients with pleural metastatic thymic tumours.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.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).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 Description:Gesehen am 25.09.2023
Physical Description:Online Resource
ISSN:2753-670X
DOI:10.1093/icvts/ivad032

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