Thymoma surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Surgery is the mainstay of treatment of thymoma. | [[Surgery]] is the mainstay of treatment of thymoma. | ||
==Surgery== | ==Surgery== | ||
*Surgery is the mainstay of treatment of thymoma. | *[[Surgery]] is the mainstay of treatment of thymoma. | ||
*If the tumor is | *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 an early stage (Masaoka I through IIB), no further therapy is necessary. | *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> | *[[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. | *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]]. | *[[Pleural]] surfaces should be examined for [[metastasis]]. | ||
*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> | *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. | *A full [[median sternotomy]] is the standard open approach. | ||
*The [[mediastinum]] must be explored for cervical thymus | *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>==== | ====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>==== | ||
Revision as of 19:18, 15 August 2019
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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
- 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 e.g. IFo or combination e.g. ADOC or 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
|month=ignored (help) - ↑ "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) - ↑ 3.0 3.1 "http://www.cancertreatmentreviews.com/article/S0305-7372(11)00249-0/abstract". External link in
|title=(help)