Treatment strategies for thymoma with pleural dissemination or pleural recurrence

doi:10.3877/cma.j.issn.2095-8773.2024.04.05

Abstract

Abstract:

Thymoma is the most common pathological type of tumor in the anterior mediastinum.The pleura is the hotspot for thymoma metastasis，known as the “host site”，and pleural implantation metastasis is a special mode of thymoma metastasis.Pleural metastasis of thymoma may already exist in the initial diagnosis，representing stage M1a thymoma； or it may occur during the follow-up period after treatment，indicating pleural recurrence.Surgery is an important treatment for thymoma with pleural dissemination or pleural recurrence.Currently，there is no international expert consensus on the approach，method selection，and other aspects of surgical resection of thymoma.Surgery alone is diきcult to achieve complete resection of thymoma with pleural dissemination or pleural recurrence.Thoracic hyperthermic perfusion chemotherapy is an effective supplementary treatment method.However，the selection and condition settings for thoracic hyperthermic perfusion chemotherapy are still in the exploratory period.Previous studies were mainly small-size，retrospective，and uncontrolled studies，with many confounding factors and limited clinical experience.This article summarizes and analyzes the diagnosis of thymoma with pleural dissemination or pleural recurrence and treatment progress of the combination of surgery and thoracic hyperthermic perfusion chemotherapy，providing a theoretical basis for reasonable treatment selection and developing personalized treatment strategies.

Key words: Thymoma, Pleural dissemination, Hyperthermic intrathoracic chemotherapy, Complete resection, Pleural recurrence

Shuai Wang, Yongqiang Ao, Jianyong Ding. Treatment strategies for thymoma with pleural dissemination or pleural recurrence[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2024, 11(04): 236-241.

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References 16

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研究	病例	化疗药物	持续时间（min）	温度（℃）	手术	围手术期发病率（%）	总体生存率
Maury等^[8]	19	顺铂（50 mg/m² BSA）；丝裂霉素（25 mg/m² BSA）	90	42	P/D，EPP	16	5年：86%
Yellin等^[9]	35	顺铂（100 mg/m² BSA）；多柔比星（50～60 mg）	60	43	P/D，EPP	29	5年：67%
Refaely等^[10]	15	顺铂（100 mg/m² BSA）	60	42	P/D，EPP	40	5年：70%
de ree等^[11]	3	顺铂（80 mg/m² BSA）；多柔比星（15～30 mg/m² BSA）	90	40～41	P/D，EPP	33	18个月：100%
Ried等^[12]	8	顺铂（100～150 mg/m² BSA）	60	42	P/D	24	22个月：87.5%
Yu等^[13]	4	顺铂（100 mg/m² BSA）	120	41～43	CRS	25	4年：75%

研究	病例	化疗药物	持续时间（min）	温度（℃）	手术	围手术期发病率（%）	总体生存率
Maury等^[8]	19	顺铂（50 mg/m² BSA）；丝裂霉素（25 mg/m² BSA）	90	42	P/D，EPP	16	5年：86%
Yellin等^[9]	35	顺铂（100 mg/m² BSA）；多柔比星（50～60 mg）	60	43	P/D，EPP	29	5年：67%
Refaely等^[10]	15	顺铂（100 mg/m² BSA）	60	42	P/D，EPP	40	5年：70%
de ree等^[11]	3	顺铂（80 mg/m² BSA）；多柔比星（15～30 mg/m² BSA）	90	40～41	P/D，EPP	33	18个月：100%
Ried等^[12]	8	顺铂（100～150 mg/m² BSA）	60	42	P/D	24	22个月：87.5%
Yu等^[13]	4	顺铂（100 mg/m² BSA）	120	41～43	CRS	25	4年：75%

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