title: Multidisciplinary treatment of malignant thymoma.
abstract: OBJECTIVE
  Thymomas are the most common tumors of the anterior mediastinum. Although surgery remains the only curative treatment, the use of multimodality therapy for primary unresectable thymomas has led to change the clinical management of these tumors.
  
  
  RESULTS
  Nowadays Masaoka stage, WHO, and radical surgical resection are considered by many authors as independent prognostic factors for long-term survival. Radiotherapy may be useful as adjuvant therapy in cases of incomplete surgical resection with microscopic or macroscopic residual disease, or for those patients with locally advanced or metastatic unresectable disease. Chemotherapy is considered a valid option in selected patients with residual disease after local treatments or as a neoadjuvant approach to improve resectability in Masaoka stages III or IV-a thymomas. Currently, no standardized regimen for chemotherapy or agreed timing exists.
  
  
  CONCLUSIONS
  So far, multimodality treatment has been related to low morbidity and long survival rate, but there are still many concerns regarding a different regimen of therapy and the correct timing.
authors.affiliation: Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy. lorenzo.spaggiari@ieo.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Spaggiari
authors.forename: Monica
authors.initials: M
authors.lastname: Casiraghi
authors.forename: Juliana
authors.initials: J
authors.lastname: Guarize
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D015996:Survival Rate; D013934:Thymectomy; D013945:Thymoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D013953:Thymus Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*