Induction Therapy Followed by Surgery for Unresectable Thymic Epithelial Tumours

Overview

Journal Front Oncol

Specialty Oncology

Date 2022 Jan 24

PMID 35070999

Authors

Shuai Wang

Jiahao Jiang

Jian Gao

Gang Chen

Yue Fan

Bei Xu

Jihong Dong

Shisuo Du

Junzhen Liu

Jianyong Ding

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: The treatment of unresectable thymic epithelial tumours (TETs) remains controversial. Here, we present the efficacy and safety of induction therapy followed by surgery for unresectable TET.

Methods: Eighty-one patients with unresectable TETs treated with induction therapy followed by surgery were selected from a retrospective review of consecutive TETs from January 2005 to January 2021. Clinicopathological data were analyzed to assess tumour responses, resectability, adverse events, progression-free survival (PFS) and overall survival (OS).

Results: Induction therapy produced a major tumour response rate of 69.1%, a tumour response grade (TRG) 1-3 rate of 84.0% and an R0 resection rate of 74.1%. The most common toxic effects were all-grade neutropenia (35.8%) and anaemia (34.6%). The 10-year OS and PFS rates were 45.7% and 35.2%. Multivariate analysis showed that ypTNM stage, ypMasaoka stage, complete resection, and TRG were significant independent prognostic factors. Exploratory research revealed that different induction modalities and downstaging of T, N, M, TNM, or Masaoka classifications did not significantly alter the pooled hazard ratio for survival.

Conclusions: Induction therapy followed by surgery is well tolerated in patients with unresectable TETs, with encouraging R0 resection rates. Multimodality management provides good control of tumors for unresectable TET patients.

Citing Articles

Re-evaluation and operative indications after induction therapy for thymic epithelial tumors.

Yamada Y, Hamaji M, Okada H, Takahagi A, Ajimizu H, Koyasu S Mediastinum. 2024; 8:43.

PMID: 39161585 PMC: 11330912. DOI: 10.21037/med-23-70.

Perioperative management and postoperative outcomes of locally advanced thymic epithelial tumors: a narrative review.

Takenaka M, Kuroda K, Tanaka F Mediastinum. 2024; 8:7.

PMID: 38322188 PMC: 10839523. DOI: 10.21037/med-23-24.

Prognosis of Concurrent Versus Sequential Chemo-Radiotherapy Induction Followed by Surgical Resection in Patients with Advanced Thymic Epithelial Tumors: A Retrospective Study.

Guan S, Long W, Liu Y, Cai B, Luo J Ann Surg Oncol. 2023; 30(11):6739-6747.

PMID: 37454019 DOI: 10.1245/s10434-023-13954-x.

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