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NCI CANCERLIT® Search: Malignant Thymoma - March 2002
National Cancer Institute®
Last Modified: March 1, 2002
Table of Contents
1
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.
meinosin@surg1.med.osaka-u.ac.jp
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
2
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
3
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.
4
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.
kitami.a@showa-university-fujigaoka.gr.jp
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.
5
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.
azrios@teleline.es
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.
6
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. iyoshino@surg2.med.kyushu-u.ac.jp
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.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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