Thymoma surgery: Difference between revisions
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(/* Relapse Treatment Algorithm{{Cite web | last = | first = | title = http://www.cancertreatmentreviews.com/article/S0305-7372(11)00249-0/abstract | url = http://www.cancertreatmentreviews.com/article/S0305-7372(11)00249-0/abstract | publisher = |...) |
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__NOTOC__ | __NOTOC__ | ||
{{Thymoma}} | {{Thymoma}} | ||
{{CMG}} {{AE}} {{AM}} | {{CMG}} {{AE}} {{AM}} {{AAM}} | ||
==Overview== | |||
[[Surgery]] is the mainstay of treatment of thymoma. | |||
==Surgery== | |||
*[[Surgery]] is the mainstay of treatment of thymoma. | |||
*If the [[tumor]] is [[Gross examination|grossly]] [[Invasive (medical)|invasive]] and large, [[Neoadjuvant chemotherapy|preoperative (neoadjuvant) chemotherapy]] and/or [[Radiation therapy|radiotherapy]] may be used to decrease the size and improve [[Resection|resectability]], before [[surgery]] is attempted. | |||
*When the [[tumor]] is at an early stage (Masaoka I through IIB), no further [[therapy]] is necessary. | |||
*[[Malignant tumors]] may need additional treatment with [[radiotherapy]], or sometimes with [[chemotherapy]], such as [[cyclophosphamide]], [[doxorubicin]], and [[cisplatin]].<ref name="pmid10561285">{{cite journal |author=Thomas CR, Wright CD, Loehrer PJ |title=Thymoma: state of the art |journal=[[Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology]] |volume=17 |issue=7 |pages=2280–9 |year=1999 |month=July |pmid=10561285 |doi= |url=http://www.jco.org/cgi/pmidlookup?view=long&pmid=10561285 |accessdate}}</ref> | |||
*Complete [[resection]] may require [[resection]] of the adjacent structures, including [[pleura]], [[lungs]], [[pericardium]], [[phrenic nerves]], and sometimes major [[vascular]] structures. | |||
*[[Pleural]] surfaces should be examined for [[metastasis]]. | |||
*There is no long term data to support minimally [[Invasive (medical)|invasive]] procedures.<ref>{{Cite web | last = | first = | title = https://www.nccn.org/store/login/login.aspx?ReturnURL=http://www.nccn.org/professionals/physician_gls/pdf/thymic.pdf | url = https://www.nccn.org/store/login/login.aspx?ReturnURL=http://www.nccn.org/professionals/physician_gls/pdf/thymic.pdf | publisher = | date = | accessdate = }}</ref> | |||
*A full [[median sternotomy]] is the standard open approach. | |||
*The [[mediastinum]] must be explored for [[cervical]] [[thymus]] extension. | |||
== | ====Primary Diagnosis Treatment Algorithm<ref name="www.cancertreatmentreviews.com">{{Cite web | last = | first = | title = http://www.cancertreatmentreviews.com/article/S0305-7372(11)00249-0/abstract | url = http://www.cancertreatmentreviews.com/article/S0305-7372(11)00249-0/abstract | publisher = | date = | accessdate = }}</ref>==== | ||
<br> | |||
{{familytree/start |summary=PE diagnosis Algorithm.}} | |||
{{familytree | | | |,|-| A01 |-|-|-|-|-|-|-|.| |A01=Stage I }} | |||
{{familytree | | | |!| | | | | | | | | | | |!| | | | | | }} | |||
{{familytree | | | |!| | | | | | | | | | | |!| | | | | | }} | |||
{{familytree | | C01 | | C02 |-|-|-|-|-|-|.|!| |C01=Diagnosis of thymoma |C02=Resectable }} | |||
{{familytree | | | |!| | | |!| | | | | | |!|!| | | | | | }} | |||
{{familytree | | | |!| | | |!| B01 |-|-|-| B02 |-|-|-|-| B03 |-|-| B04 | | | | | |B01=Chemotherapy single agent (ifosfamide) or combination (ADOC/CAPP) |B02=Surgical resection |B03=Incomplete resection |B04=Radio/chemo therapy }} | |||
{{familytree | | | |!| | | |!| |!| | | | | |!| | | | | | }} | |||
{{familytree | | | |!| | | |!| |!| | | | | |!| | | | | | }} | |||
{{familytree | | | |!| | | |!| |!| | | | | |!| | | | | | }} | |||
{{familytree | | | |!| | | |!| |!| | | | | |!| | | | | | }} | |||
{{familytree | | | |`|-| E01 |-| E02 |-| E03 | |E01=Stage II/III/IV |E02=Unresectable |E03=Radiotherapy }} | |||
{{familytree/end}} | |||
<br> | |||
== | ====Relapse Treatment Algorithm<ref name="www.cancertreatmentreviews.com">{{Cite web | last = | first = | title = http://www.cancertreatmentreviews.com/article/S0305-7372(11)00249-0/abstract | url = http://www.cancertreatmentreviews.com/article/S0305-7372(11)00249-0/abstract | publisher = | date = | accessdate = }}</ref>==== | ||
<br> | |||
{{familytree/start |summary=Relapse}} | |||
{{familytree | | | | | | | | A01 |A01=Relapse}} | |||
{{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }} | |||
{{familytree | | | B01 | | | | | | |,| B02 |.| |B01=Resectable|B02=Unresectable}} | |||
{{familytree | | | |!| | | | | | | |!| | | |!| | }} | |||
{{familytree | | | |!| | | | | | | C02 | | C03 | | | |C02=Radiotherapy |C03=Corticosteroids/Octreotide }} | |||
{{familytree | | | |!| | | | | | | |!| | | |!| | }} | |||
{{familytree | | | C01 |-|-|-|-|-|-|^|-|-|-|'| | | |C01=Surgical resection }} | |||
{{familytree | | | |!| | | | | | | | | | | | | | }} | |||
{{familytree | | | D01 | | | | | | | | | | | | |D01=Incomplete resection}} | |||
{{familytree | | | |!| | | | | | | | | | | | }} | |||
{{familytree | | | E01 | | | | | | | | | | |E01=Radiotherapy}} | |||
{{familytree | | | | | | | | | | | | | | | | | }} | |||
{{familytree | | | | | | | | | | | | | | | | | }} | |||
{{familytree/end}} | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Types of cancer]] | [[Category:Types of cancer]] | ||
[[Category:Rare diseases]] | [[Category:Rare diseases]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
[[Category:Hematology]] | |||
[[Category:Immunology]] | |||
[[Category:Surgery]] |
Latest revision as of 19:23, 15 August 2019
Thymoma Microchapters |
Diagnosis |
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Case Studies |
Thymoma surgery On the Web |
American Roentgen Ray Society Images of Thymoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2] Ahmad Al Maradni, M.D. [3]
Overview
Surgery is the mainstay of treatment of thymoma.
Surgery
- Surgery is the mainstay of treatment of thymoma.
- If the tumor is grossly invasive and large, preoperative (neoadjuvant) chemotherapy and/or radiotherapy may be used to decrease the size and improve resectability, before surgery is attempted.
- When the tumor is at an early stage (Masaoka I through IIB), no further therapy is necessary.
- Malignant tumors may need additional treatment with radiotherapy, or sometimes with chemotherapy, such as cyclophosphamide, doxorubicin, and cisplatin.[1]
- Complete resection may require resection of the adjacent structures, including pleura, lungs, pericardium, phrenic nerves, and sometimes major vascular structures.
- Pleural surfaces should be examined for metastasis.
- There is no long term data to support minimally invasive procedures.[2]
- A full median sternotomy is the standard open approach.
- The mediastinum must be explored for cervical thymus extension.
Primary Diagnosis Treatment Algorithm[3]
Stage I | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Diagnosis of thymoma | Resectable | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Chemotherapy single agent (ifosfamide) or combination (ADOC/CAPP) | Surgical resection | Incomplete resection | Radio/chemo therapy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Stage II/III/IV | Unresectable | Radiotherapy | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Relapse Treatment Algorithm[3]
Relapse | |||||||||||||||||||||||||||||||||||||||
Resectable | Unresectable | ||||||||||||||||||||||||||||||||||||||
Radiotherapy | Corticosteroids/Octreotide | ||||||||||||||||||||||||||||||||||||||
Surgical resection | |||||||||||||||||||||||||||||||||||||||
Incomplete resection | |||||||||||||||||||||||||||||||||||||||
Radiotherapy | |||||||||||||||||||||||||||||||||||||||
References
- ↑ Thomas CR, Wright CD, Loehrer PJ (1999). "Thymoma: state of the art". Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 17 (7): 2280–9. PMID 10561285. Text "accessdate" ignored (help); Unknown parameter
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