Three surgical cases of Stage III/IVa thymoma: Assessment of the significance of induction therapy

摘要

Background. The efficacy of induction therapy in Stage III/IVa thymoma (Masaoka's criteria) is controversial. Cases. We reviewed the clinical records of three patients operated on for a Stage III/IVa thymoma who had undergone induction therapy. Two patients were in Stage III and one was in Stage IVa. The superior vena cava was involved in two patients, the left brachiocephalic vein in one, the ascending aorta in one, the right atrium in one, and the pericardium in one. One patient each underwent radiotherapy, both chemoradiotherapy and chemotherapy, and chemotherapy as induction therapy. In radiotherapy an irradiation dose of 40 to 66 Gy was applied to the mediastinum. ADOC therapy (cisplatin, vincristine, adriamycin, cyclophosphamide) was given as chemotherapy. All patients showed partial remission after induction therapy as assessed based on the CT scan. All patients underwent extended complete thymectomy and concomitant resection of other organs. One patient underwent chemoradiotherapy for postoperative adjuvant therapy. All patients are alive without any sign of recurrence. Conclusion. It has been suggested by our experience and other researchers that multimodality treatment (preoperative chemotherapy, extended resection and postoperative chemoradiotherapy) improves the outcome of patients with Stage III/IVa thymoma.