Current readings: The most influential and recent studies involving surgical management of thymoma.
Thymic epithelial tumors can be challenging to manage because of local invasion of mediastinal structures and high recurrence rates. Surgery is the mainstay of treatment and complete resection is associated with the best prognosis. Although practices vary, neoadjuvant chemotherapy is often used to improve resectability. Extended resections following neoadjuvant treatment have been safely performed for locally advanced tumors. R0 resection should be the goal and should dictate the surgical approach and extent of resection. Postoperative radiation therapy has often been used to reduce the risk of recurrence after resection. No study has definitively shown a recurrence or survival benefit with postoperative radiation therapy in completely resected tumors. However, there are some data to support its use in patients with residual disease. As our knowledge has largely been derived from small series, larger multicenter collaborative efforts are needed to improve our understanding of this disease.
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
Usman
U
Ahmad
James
J
Huang
chemotherapy; radiation therapy; thymectomy; thymoma