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Preoperative induction therapy for locally advanced thymic tumors: a retrospective analysis using the ChART database

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机构: [1]Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao 266001, China [2]Department of Thoracic Surgery, ShanghaiChest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China [3]Department of Thoracic Surgery, Guangdong Esophageal CancerInstitute, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of CancerMedicine, Guangzhou 510060, China [4]Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China [5]Department of Endocrinology, Tianjin Medical University General Hospital, Tianjin 300052, China [6]Department of Thoracic Surgery, SichuanCancer Hospital, Chengdu 610041, China [7]Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China [8]Department of Thoracic Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China [9]Department of Thoracic Surgery,Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China [10]Department of Thoracic Surgery, Beijing Cancer Hospital, Beijing100142, China [11]Department of Cardiothoracic Surgery, Changhai Hospital, Shanghai 200433, China [12]Department of Thoracic Surgery, LiaoningCancer Hospital, Shenyang 110042, China [13]Department of Thoracic Surgery, First Affiliated Hospital of Jilin University, Changchun 130021,China [14]Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China [15]Department of Thoracic Surgery,Huashan Hospital, Fudan University, Shanghai 200032, China [16]Department of Esophageal Cancer, Tianjin Cancer Hospital, Tianjin 300060,China [17]Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China [18]Department of Thoracic Surgery, Jiangxi People’sHospital, Nanchang 330006, China
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关键词: Thymic malignancy induction therapy surgery survival

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Background: To evaluate the role of preoperative induction therapy on prognosis of locally advanced thymic malignancies. Methods: Between 1994 and 2012, patients received preoperative induction therapies (IT group) in the Chinese Alliance for Research in Thymomas (ChART) database, were compared with those having surgery directly after preoperative evaluation (DS group). All tumors receiving induction therapies were locally advanced (clinically stage III-IV) before treatment and those turned out to be in pathological stage I and II were considered downstaged by induction. Clinical pathological characteristics were retrospectively analyzed. To more accurately study the effect of induction therapies, stage IV patients were then excluded. Only stage I-III tumors in the IT group and stage III cases in the DS group were selected for further comparison in a subgroup analysis. Results: Only 68 (4%) out of 1,713 patients had induction therapies, with a R0 resection of 67.6%, 5-year recurrence of 44.9%, and 5- and 10-year overall survivals (OS) of 49.7% and 19.9%. Seventeen patients (25%) were downstaged after induction. Significantly more thymomas were downstaged than thymic carcinomas (38.7% vs. 13.9%, P=0.02). Tumors downstaged after induction had significantly higher 5-year OS than those not downstaged (93.8% vs. 35.6%, P=0.013). For the subgroup analysis when stage IV patients were excluded, 5-year OS was 85.2% in the DS group and 68.1% in the IT group (P=0.000), although R0 resection were similar (76.4% vs. 73.3%, P=0.63). However, 5-year OS in tumors downstaged after induction (93.8%) was similar to those in the DS group (85.2%, P=0.438), both significantly higher than those not downstaged after induction (35.6%, P=0.000). Conclusions: Preoperative neoadjuvant therapy have been used only occasionally in locally advanced thymic malignances. Effective induction therapy leading to tumor downstaging may be beneficial for potentially unresectable diseases, especially in patients with thymomas. These findings would be helpful to related studies in the future.

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出版当年[2016]版:
大类 | 4 区 医学
小类 | 4 区 呼吸系统
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 呼吸系统
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出版当年[2016]版:
Q3 RESPIRATORY SYSTEM
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Q3 RESPIRATORY SYSTEM

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第一作者机构: [1]Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao 266001, China
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通讯机构: [1]Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao 266001, China [*1]Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao 266003, China. [*2]Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
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