ReviewMediastinum (Hong Kong, China)2026
Narrative review: locally advanced thymoma-do we really need induction therapy before extended resection?
Review in Mediastinum (Hong Kong, China), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Objective: Locally advanced thymoma remains a challenging condition in which complete tumour clearance may require extended surgical resection. Induction therapy, including chemotherapy or chemoradiotherapy, is used in selected patients to improve resectability; however, the evidence supporting its routine use remains limited. This narrative review evaluates the role of induction therapy before extended resection, with particular attention to patient selection, resectability assessment, and multidisciplinary decision-making. Methods: A structured narrative review was conducted using PubMed/MEDLINE, supplemented by manual screening of reference lists from relevant articles, reviews, registry analyses, and guideline documents. The original search covered the period from January 1990 to April 2026 and was updated on 21 June 2026 during revision. Search terms included combinations of "thymoma", "thymic epithelial tumours", "locally advanced", "induction therapy", "neoadjuvant treatment", "preoperative chemotherapy", "chemoradiotherapy", "resectability", "borderline resectable", and "extended resection". English-language clinical studies, systematic and narrative reviews, registry analyses, and international guidelines were considered. Key Content and Findings: The available evidence is largely derived from retrospective, heterogeneous studies, often including mixed populations of thymoma and thymic carcinoma. Platinum-based regimens can achieve radiologic response rates of approximately 50-70%, but no prospective or randomised data demonstrate a clear survival advantage over upfront surgery in clearly resectable thymoma. Induction therapy may provide practical advantages in selected anatomically complex or borderline-resectable cases, including tumour bulk reduction, improved operative planning, and potential facilitation of margin-negative resection. However, radiologic response does not necessarily indicate true pathologic downstaging or reduced need for Conclusions: Extended surgical resection remains the standard of care when complete resection appears achievable upfront. Current evidence is insufficient to support routine induction therapy in clearly resectable locally advanced thymoma, although induction treatment remains appropriate in selected borderline-resectable cases in which preoperative therapy may improve the likelihood or quality of complete resection. Further prospective and collaborative studies are needed to refine patient selection and clarify its role.
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