[Preoperative chemotherapy and operation for invasive Masaoke stage III and IV a thymoma].
OBJECTIVE
To assess the effect of preoperative chemotherapy on invasive thymoma.


METHODS
Fourteen patients with invasive thymoma (12 cases in Masaoka stage III and 2 cases in stage IV a) were treated with 3-4 cycles of CAVP (cyclophosphamide 600 mg/m2 D1, adriamycin 30 mg/m2 or epi-adriamycin 40 mg/m2 D1, vincristine 0.6 mg/m2 D1 or vindestine 3 mg/m2 D1, D8, cisplatin 30 mg/m2 D1, 2, 3). Following chemotherapy, patients were operated within 1-3 months. In 10 patients, sternotomy was performed and in 4 patients, anterolateral thoracotomy was performed. Radiotherapy was given with a total dose of 50-60 Gy in all patients except in those who were pathologically in complete remission. The patients were followed up for 6 months to 3 years.


RESULTS
After chemotherapy, complete response was observed in 5 patients (35.7%) and partial response in 9 patients (64.3%). Nine patients received radical tumor resection and 5 patients received partial resection. Histologic/examination of the surgical specimens showed fibrosis of the remnant thymus in 5 patients. All but two patients survived in the follow-up period. Patient died from distant metastases at 18 and 24 months after treatment, respectively.


CONCLUSIONS
Preoperative chemotherapy helps increase the resectability of stage III and IV a invasive thymoma. A longer follow-up period and more patients are needed to ascertain the impact of this treatment strategy on long-term survival.
Tan
L
L
Department of Thoracic Surgery, Zhong Shan Hospital, Shanghai Medical University, Shanghai 200032, China.
Qiu
D
D
Wang
Q
Q
D000328:Adult; D004358:Drug Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011300:Preoperative Care; D013945:Thymoma / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome