National Cancer Institute®
Last Modified: March 1, 2002
UI - 11857293
AU - Okumura M; Ohta M; Tateyama H; Nakagawa K; Matsumura A; Maeda H; Tada H;
TI - Eimoto T; Matsuda H; Masaoka A The World Health Organization histologic classification system reflects the oncologic behavior of thymoma: a clinical study of 273 patients.
SO - Cancer 2002 Feb 1;94(3):624-32
AD - Division of General Thoracic Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. firstname.lastname@example.org
BACKGROUND: Although the histologic classification of thymic epithelial tumors has been confusing and controversial, an agreement on the universal classification system for thymic epithelial tumors was achieved by the World Health Organization (WHO) in 1999. The authors previously reported that the WHO histologic classification system reflects invasiveness and immunologic function of thymic epithelial tumors. In this subsequent study, they examined the prognostic significance of this classification system. METHODS: Clinical features as well as postoperative survival of patients with thymoma, but not thymic carcinoma, were examined with reference to WHO histologic classification based on an experience with 273 patients over a 44-year period. RESULTS: There were 18 type A tumors, 77 type AB tumors, 55 type B1 tumors, 97 type B2 tumors, and 26 type B3 tumors. In patients with type A, AB, B1, B2, and B3 tumors, the respective proportions of invasive tumor were 11.1%, 41.6%, 47.3%, 69.1%, and 84.6%; the respective proportions of tumors with involvement of the great vessels were 0%, 3.9%, 7.3%, 17.5%, and 19.2%; and the respective 20-year survival rates were 100%, 87%, 91%, 59%, and 36%. According to the Masaoka staging system, the 20-year survival rates were 89%, 91%, 49%, 0%, and 0% in patients with Stage I, II, III, IVa, and IVb disease, respectively. By multivariate analysis, the Masaoka staging system and the WHO histologic classification system were significant independent prognostic factors, whereas age, gender, association with myasthenia gravis, completeness of resection, or involvement of the great vessels were not significant independent prognostic factors. CONCLUSIONS: This study showed that histologic appearance reflects the oncologic behavior of thymoma when the WHO classification system is adopted. The WHO classification system may be helpful in clinical practice for the assessment and treatment of patients with thymoma. Copyright 2002 American Cancer Society. DOI 10.1002/cncr.10225
UI - 11523416
AU - Sokolov AN; Savchenko VG; Trakhtenberg AKh; Andreev IuN; Tochenov AV;
TI - Isaev VG; Skidan NI; Chemis AG; Vishnevskaia ES; Togonidze DK [Effective combined treatment of thymus carcinoma with complete eradication of tumor after neoadjuvant therapy in a patient with severe form of hemophilia A]
SO - Ter Arkh 2001;73(7):70-2
UI - 11834661
AU - de Bree E; van Ruth S; Baas P; Rutgers EJ; van Zandwijk N; Witkamp AJ;
TI - Zoetmulder FA Cytoreductive surgery and intraoperative hyperthermic intrathoracic chemotherapy in patients with malignant pleural mesothelioma or pleural metastases of thymoma.
SO - Chest 2002 Feb;121(2):480-7
AD - Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
STUDY OBJECTIVES: No established curative treatment is available for pleural thymoma metastases and malignant pleural mesothelioma (MPM). Recently, peritoneal malignancies have been treated by cytoreductive surgery and intraoperative hyperthermic intracavitary perfusion chemotherapy (HIPEC). We investigated the feasibility and safety of this multimodality treatment in the thoracic cavity. DESIGN: Patients with pleural thymoma metastases or early-stage MPM were enrolled in a feasibility study. Morbidity, recurrence, and survival rates were recorded. SETTING: The Netherlands Cancer Institute. PATIENTS: Three patients with pleural thymoma metastases and 11 patients with pleural mesothelioma were treated. INTERVENTIONS: Cytoreductive surgery and intraoperative hyperthermic intrathoracic perfusion chemotherapy (HITHOC) with cisplatin and adriamycin were performed. The mesothelioma patients received adjuvant radiotherapy on the thoracotomy wound and drainage tracts. MEASUREMENTS AND RESULTS: Morbidity and mortality rates were 47% and 0%, respectively. Reoperation was necessary in four cases. Severe chemotherapy-related complications were not observed. A solitary mediastinal and a contralateral pleural thymoma recurrence were successfully treated by radiotherapy and a contralateral HITHOC procedure. All thymoma patients were alive and free of disease after a mean follow-up period of 18 months. After a mean follow-up period of 7.4 months, nine mesothelioma patients are alive. Two mesothelioma patients died of contralateral pleural and peritoneal recurrent disease, while one patient is alive with locoregional recurrence. CONCLUSIONS: Cytoreductive surgery and HITHOC with cisplatin and adriamycin is feasible in patients with pleural thymoma metastases and early-stage MPM, and is associated with acceptable morbidity rates. Early data on locoregional disease control are encouraging, and a phase II study will be conducted.
UI - 11902491
AU - Kitami A; Suzuki T; Kamio Y; Suzuki S
TI - Chemotherapy of thymic carcinoma: analysis of seven cases and review of the literature.
SO - Jpn J Clin Oncol 2001 Dec;31(12):601-4
AD - Department of Thoracic and Cardiovascular Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan. email@example.com
BACKGROUND: Thymic carcinoma has a dismal prognosis compared with thymoma, because most of such tumors have locoregional invasion when diagnosed. Thus the important step in the management of thymic carcinoma is the introduction of systemic chemotherapy. However, as thymic carcinoma is a rare neoplasm, treatment with chemotherapy has not been studied systematically. METHODS: We analyzed seven cases of primary thymic carcinoma, treated with various chemotherapy regimens in our hospital from 1990 to 1999, and carried out a literature review of case reports of thymic carcinoma successfully treated with chemotherapy. RESULTS: All four cases who received modified ADOC therapy obtained partial responses. Other chemotherapeutic regimens (CHOP-E, PVB) were not effective. CONCLUSION: Based on the results of this study and the literature review, we feel that a positive response is obtainable with chemotherapy for thymic carcinoma. Modified ADOC therapy showed consistent efficacy in thymic carcinoma in this study.
UI - 11825741
AU - Rios A; Torres J; Galindo PJ; Roca MJ; Rodriguez JM; Sola J; Parrilla P
TI - Prognostic factors in thymic epithelial neoplasms.
SO - Eur J Cardiothorac Surg 2002 Feb;21(2):307-13
AD - Department of General Surgery and Digestive Apparatus I, Virgen de la Arrixaca University Hospital, 30120, El Palmar, Murcia, Spain. firstname.lastname@example.org
OBJECTIVES: The primary thymic epithelial neoplasms (PTENs) are uncommon tumours with a broad spectrum of both biological and morphological features. The aim of this study is to analyse the prognostic factors that influence survival. METHODS: Forty-four patients with a complete follow-up were analysed. Nine patients (20.5%) were asymptomatic, the most common symptoms in the rest being myasthenia gravis and dyspnoea. All the patients underwent surgery, 30 cases (68.2%) receiving total thymectomy and the rest a partial resection or biopsy. Marino-Muller's histological classification showed the mixed type to be the most common (52.3%). Clinical staging was done according to the Masaoka classification, which gave the most common stage as stage III (34.1%). RESULTS: Twelve patients died during a mean follow-up of 8.2 +/- 3.5 years. The accumulated survival rate was 77% at 5 years and 60% at 10 years. Analysis of the survival curves shows significant differences (P<0.05) when considering surgical technique, clinical staging and histological subtype. The multivariate analysis shows the only parameters with prognostic significance in PTENs to be clinical staging and histological type (P<0.001). CONCLUSIONS: The most important prognostic factors in PTENs are Masaoka's clinical staging and Marino-Muller's histological subtype.
UI - 11899204
AU - Yoshino I; Kase S; Yano T; Sugio K; Sugimachi K
TI - Expression status of E-cadherin and alpha-, beta-, and gamma-catenins in thymoma.
SO - Ann Thorac Surg 2002 Mar;73(3):933-7
AD - Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. email@example.com
BACKGROUND: A loss or dysfunction of E-cadherin or catenins, which maintain tissue integrity, is associated with an invasive phenotype of various solid tumors. Therefore, we analyzed the expression of E-cadherin and alpha-catenin, beta-catenin, and gamma-catenin in thymoma tissue specimens to investigate its clinical significance. METHODS: The expressions of E-cadherin and alpha-catenin, beta-catenin, and gamma-catenin in thymoma tissues were evaluated in 21 patients, including 9 epithelial predominant type, 5 lymphocytic predominant type, and 7 mixed type patients based on an immunohistochemical analysis using monoclonal antibodies, and the relationship between the expression status and clinicopathologic features was investigated. RESULTS: Reduced expressions were observed in 11 patients (52%) for E-cadherin, 10 (45%) for alpha-catenin, 6 (27%) for beta-catenin, and 10 (45%) for gamma-catenin. Such an expression status (reduced or preserved) of the molecules closely correlated with each other. The expression of E-cadherin was well preserved in 5 of 5 patients with lymphocyte predominant type whereas E-cadherin was reduced in 11 of 17 patients with other histologic subtypes. All of the 9 cortex type thymomas (B1 to 3) showed preserved expression of beta-catenin. There was no significant relationship among the expressions of the molecules and the Masaoka stage classification (I versus others). CONCLUSIONS: The status of expressions for these molecules may affect the degree of lymphoid infiltration while not affecting the degree of invasiveness in thymoma.
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