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Related Experiment Video

Updated: Jul 19, 2025

Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer

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Locally advanced thymoma; does neoadjuvant chemotherapy make a difference?

Riad Abdel Jalil¹, Farah A Abdallah², Zeinab Obeid²

¹Department of Thoracic Oncology, King Hussein Cancer Center, Queen Rania Al Abdullah Street, P.O. Box 1269, Amman, 11941, Jordan. Da.06648@khcc.jo.

Journal of Cardiothoracic Surgery

|August 17, 2023

Summary

Neoadjuvant chemotherapy (NACT) for locally advanced thymoma showed minimal radiologic and pathologic effects. This approach did not significantly improve oncological outcomes compared to upfront surgery, and recurrence risk was higher in the NACT group.

Keywords:

Histopathological effect Neoadjuvant chemotherapy Radiographic effect Thymoma

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Area of Science:

Oncology
Thoracic Surgery
Cancer Research

Background:

Thymoma is the most common primary tumor of the anterior mediastinum.
Surgical resection (thymectomy) is the primary treatment for thymoma.
Neoadjuvant chemotherapy (NACT) is considered for locally advanced or borderline resectable thymoma to improve R0 resection rates.

Purpose of the Study:

To evaluate the efficacy and safety of neoadjuvant chemotherapy (NACT) in locally advanced thymoma.
To assess the impact of NACT on tumor burden using radiological and pathological criteria.
To compare oncological outcomes between patients receiving NACT and those undergoing upfront surgery.

Main Methods:

Retrospective analysis of 23 thymoma patients treated between 2015-2021.
Tumor burden assessed using CT scans and RECIST criteria.
Pathological response evaluated by measuring tumor necrosis percentage.

Main Results:

NACT showed minimal effect on tumor burden (RECIST stable disease in 8/12 patients).
Average tumor necrosis was 39.5%, with no significant change in tumor volume.
The NACT group had a higher recurrence rate (33.3%) and shorter mean survival (43.8 months) compared to upfront surgery.

Conclusions:

NACT did not significantly improve oncological outcomes in locally advanced thymoma compared to upfront surgery.
Radiological and pathological assessments indicated minimal benefit from NACT.
Multicentric studies are recommended to further clarify the role of induction chemotherapy.