Pleuropneumonectomy for the treatment of Masaoka stage IVA thymoma.
BACKGROUND
The treatment of locally advanced Masaoka stage IVA thymoma is not standardized and is problematic.


METHODS
A single-institution retrospective study was made of 5 patients with World Health Organization B3 thymomas who underwent pleuropneumonectomy for locally advanced thymoma. Two patients had recurrent thymoma and 3 presented de novo with stage IVA disease. Patients had a variety of induction and adjuvant treatments.


RESULTS
There was no operative mortality, and only 1 patient had a major complication. Several patients had relatively prolonged disease-free survival. The median survival was 86 months, and the Kaplan-Meier survival was 75% (95% confidence interval: 53% to 97%) at 5 years and 50% (95% confidence interval: 25% to 75%) at 10 years.


CONCLUSIONS
Pleuropneumonectomy can be performed safely in patients with advanced thymomas and may improve survival. Highly selected patients might be cured with this approach if a complete resection is performed. While the optimal multimodality strategy for these patients is unknown, induction chemotherapy followed by resection then chemoradiotherapy seems promising.
Wright
Cameron D
CD
Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. cameron@mgh.harvard.edu
D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010994:Pleura / Q000601:surgery*; D011013:Pneumonectomy; D012189:Retrospective Studies; D016019:Survival Analysis; D013945:Thymoma / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D013953:Thymus Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy