ArticleJournal of cardiothoracic surgery2011
En bloc extended total thymectomy and extrapleural pneumonectomy in Masaoka stage IVA thymomas.
Article in Journal of cardiothoracic surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 20 citations in OpenAlex.
- Management of stage IVa thymoma with coexistence of Lambert-Eaton myasthenic syndrome and myasthenia gravis in a postpartum female case report.AME case reports · 2025Article
- Surgical treatment of thymic epithelial tumors: a narrative review.Mediastinum (Hong Kong, China) · 2024Review
- Surgical outcomes of patients with locally advanced thymic epithelial tumor undergoing induction therapy followed by surgery: a narrative review.Mediastinum (Hong Kong, China) · 2024Review
- The role of surgery in the management of locally advanced and metastatic thymoma: a narrative review.Mediastinum (Hong Kong, China) · 2021Review
- Commentary: Extrapleural pneumonectomy during myasthenic crisis: The urge to go big or go home.JTCVS techniques · 2020Article
- Multimodality therapy for thymoma patients with pleural dissemination.General thoracic and cardiovascular surgery · 2019Article
- Pleuropneumonectomy for a large thymoma with multiple pleural dissemination using median sternotomy followed by posterolateral thoracotomy.Surgical case reports · 2015Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgical excision is the primary treatment for a thymoma. However, for advanced thymoma that extends to within the thoracic cavity and for recurrent cases with pleural dissemination (Masaoka stage IVA), the appropriate treatment is controversial. We evaluated the safety of surgery and outcomes of seven patients that underwent an en bloc extended total thymectomy and extrapleural pneumonectomy for stage IVA thymomas.
methodsFrom 1994 to 2009, five patients initially diagnosed with pleural dissemination and two patients with recurrent tumors in the pleura and lungs after a total thymectomy, were identified. Seven patients had an extrapleural pneumonectomy performed. For the first operation, five patients underwent additional en bloc extended total thymectomy.
resultsTwo recurrent cases were identified 55.2 and 12.3 months after first operation. Two patients had WHO type B1-B2 tumors, two had B2, two had B2-B3, and one had a B3 tumor. The mean hospital stay was 15.3 days (range: 7-29). There was no operative mortality. Four patients had neoadjuvant chemotherapy and five were treated with adjuvant chemotherapy. The median survival was 30.6 months and the Kaplan-Meier 2-year survival was 100% (95% confidence interval: 24.6-36.6 months). One patient, who did not receive induction chemotherapy, had distant metastases after surgery.
conclusionsEn bloc extended total thymectomy and extrapleural pneumonectomy can be safely performed on selected patients with stage IVA thymomas and is expected to achieve complete local control. Although the treatment strategy has yet to be standardized, complete resection with appropriate systemic therapy may improve survival in otherwise fatal disease.
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