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Multimodality therapy for thymoma patients with pleural dissemination
Shota Nakamura1, Koji Kawaguchi2, Takayuki Fukui2
1Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. shota197065@med.nagoya-u.ac.jp.
General Thoracic and Cardiovascular Surgery
|February 7, 2019
Summary
Induction chemotherapy (CAMP therapy) followed by surgery is an effective treatment for thymoma with pleural dissemination. This multidisciplinary approach shows promising survival rates, with extrapleural pneumonectomy potentially beneficial for select patients.
Area of Science:
- Oncology
- Thoracic Surgery
- Medical Oncology
Background:
- Multidisciplinary treatment is recommended for advanced or recurrent thymoma, but strategies remain debated.
- This study investigates a multimodality approach combining induction chemotherapy (CAMP therapy) with surgery for thymoma patients presenting with pleural dissemination.
Purpose of the Study:
- To evaluate the efficacy and feasibility of induction CAMP therapy followed by surgical resection in patients with thymoma and pleural dissemination.
- To compare outcomes between extrapleural pneumonectomy (EPP) and resection of pleural dissemination (RPD) surgical approaches.
Main Methods:
- A retrospective study of 19 thymoma patients with pleural dissemination treated between 2003 and 2017.
- Patients received induction CAMP therapy (cisplatin, doxorubicin, methylprednisolone) followed by surgery, divided into EPP (n=10) and RPD (n=9) groups.
Main Results:
- Partial response to induction CAMP therapy was observed in 78.9% of patients.
- The overall five-year overall survival (5Y-OS) and progression-free survival (5Y-PFS) rates were 76.7% and 55.1%, respectively.
- The EPP group showed higher 5Y-OS (83.3%) and 5Y-PFS (83.3%) compared to the RPD group (70.0% and 29.6%, respectively).
Conclusions:
- Multidisciplinary treatment combining induction CAMP therapy and surgical resection is effective and feasible for thymoma with pleural dissemination.
- Extrapleural pneumonectomy may be a suitable option for younger patients with good cardiopulmonary function and controlled myasthenia gravis due to lower recurrence rates.
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