Thymoma surgery: Difference between revisions
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Surgery is the mainstay of treatment of thymoma. | Surgery is the mainstay of treatment of thymoma. | ||
==Surgery== | ==Surgery== | ||
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 | *Complete resection may require resection of the adjacent structures, including [[pleura]], [[lungs]], [[pericardium]], [[phrenic nerves]] and sometimes major vascular structures. | ||
There is no long term data to support minimally 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> | *Pleural surfaces should be examined for [[metastasis]]. | ||
A full [[median sternotomy]] is the standard open approach. The [[mediastinum]] must be explored for cervical thymus extensions and laterally down to the phrenic nerves. | *There is no long term data to support minimally 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 extensions and laterally down to the phrenic nerves. | |||
{{familytree/start |summary=PE diagnosis Algorithm.}} | {{familytree/start |summary=PE diagnosis Algorithm.}} | ||
{{familytree | | | |,|-| A01 |-|-|-|-|-|-|-|.| |A01=Stage I }} | {{familytree | | | |,|-| A01 |-|-|-|-|-|-|-|.| |A01=Stage I }} | ||
Revision as of 17:12, 28 September 2015
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Thymoma Microchapters |
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Diagnosis |
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Case Studies |
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Thymoma surgery On the Web |
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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
- 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.[1]
- A full median sternotomy is the standard open approach.
- The mediastinum must be explored for cervical thymus extensions and laterally down to the phrenic nerves.
| Stage I | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| **Diagnosis of thymoma | Resectable | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Chemotherapy single agent e.g. IFo or combination e.g. ADOC or CAPP | Surgical resection | Incomplete resection | Radio/chemo therapy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Stage II/III/IV | Unresectable | Radiotherapy | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| **Relapse | |||||||||||||||||||||||||||||||||||||||
| Resectable | Unresectable | ||||||||||||||||||||||||||||||||||||||
| Radiotherapy | Corticosteroids/octreotide | ||||||||||||||||||||||||||||||||||||||
| Surgical resection | |||||||||||||||||||||||||||||||||||||||
| Incomplete resection | |||||||||||||||||||||||||||||||||||||||
| Radiotherapy | |||||||||||||||||||||||||||||||||||||||
Surgery is the mainstay of treatment. If the tumor is apparently 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 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.[3]
References
- ↑ "https://www.nccn.org/store/login/login.aspx?ReturnURL=http://www.nccn.org/professionals/physician_gls/pdf/thymic.pdf" (PDF). External link in
|title=(help) - ↑ "http://www.cancertreatmentreviews.com/article/S0305-7372(11)00249-0/abstract". External link in
|title=(help) - ↑ 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
|month=ignored (help)