Title
Thymoma: a focus on current therapeutic management Thymoma: a focus on current therapeutic management
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Hagerstown, Md :Lippincott Williams & Wilkins ,
Subject
Human medicine
Source (journal)
Journal of thoracic oncology / International Association for the Study of Lung Cancer [Aurora, Colo.] - Hagerstown, Md, 2006, currens
Volume/pages
4(2009) :1 , p. 119-126
ISSN
1556-0864
ISI
000262196500021
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Thymomas are rare intrathoracic malignant tumors. Commonly used staging system is the Masaoka classification, based on peroperative and histopathological findings. Surgery is the cornerstone of the management of thymomas, initially being useful for precise histopathological diagnosis and staging, and in most cases ensuring the first step of the therapeutics simultaneously. After tumor stage, complete resection is the most constant and significant prognostic factor for progression-free and overall survival. Postoperative radiotherapy is recommended in incompletely resected thymomas. Completely resected stage II and III tumors may also benefit from adjuvant radiotherapy to reduce local recurrence rates but without impact on survival. In primary unresectable thymomas, multimodal strategy nowadays includes neoadjuvant chemotherapy, extensive surgery, adjuvant radiotherapy, and in some cases, adjuvant chemotherapy. The most popular chemotherapy regimens combine cisplatin, adriamycin, etoposide, cyclophophamide, or ifosfamide. The management of thymomas is a paradigm of cooperation between clinicians, surgeons, and pathologists from establishing the diagnosis to organizing the therapeutic strategy and evaluating the prognosis. As a consequence of their rarity, no prospective randomized trials are available and collaborative studies are warranted to evaluate and improve current therapeutic standards, taking into account recent improvements in techniques, such as robotic surgery, radiotherapy, and supportive treatments.
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