Pretreatment Biopsy for Histological Diagnosis and Induction Therapy in Thymic Tumors.
Background and objective The aim of this study is to investigate the value of pretreatment biopsy for histological diagnosis and induction therapies in the management of locally advanced thymic malignancies. Methods The clinical pathological data of patients with thymic tumors in the Chinese Allianc...
| Published in: | Chinese Journal of Lung Cancer Vol. 19; no. 7; pp. 437 - 445 |
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| Main Authors: | , , , , , , |
| Format: | research tables/charts Journal Article |
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Chinese Journal of Lung Cancer
Jul2016
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125932000&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125932000 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10093419 9014 jtl: Chinese Journal of Lung Cancer issn: 10093419 maglogo: N pubinfo: dt: Jul2016 vid: 19 iid: 7 pid: 54191 pub: Chinese Journal of Lung Cancer artinfo: ui: 125932000 125932000 125932000 10.3779/j.issn.1009-3419.2016.07.05 125932000 ppf: 437 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Pretreatment Biopsy for Histological Diagnosis and Induction Therapy in Thymic Tumors. aug: au: Jie YUE Zhitao GU Zhentao YU Hongdian ZHANG Zhao MA Yuan LIU Wentao FANG affil: Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin 300060, China sug: subj: Thymus Neoplasms Diagnosis Thymus Neoplasms Drug Therapy Chemotherapy, Cancer Methods Biopsy Human Treatment Outcomes Thoracoscopy Methods Ultrasonography Methods Survival Neoplasm Staging Thymus Neoplasms Prognosis Chemoradiotherapy Minimally Invasive Procedures Thymus Neoplasms Prevention and Control ab: Background and objective The aim of this study is to investigate the value of pretreatment biopsy for histological diagnosis and induction therapies in the management of locally advanced thymic malignancies. Methods The clinical pathological data of patients with thymic tumors in the Chinese Alliance for Research in Thymomas (ChART) who underwent biopsy before treatment from 1994 to December 2012 were retrospectively reviewed. The application trend of preoperative histological diagnosis and its influence on treatment outcome were analyzed. Results Of 1,902 cases of thymic tumors, 336 (17.1%) had undergone biopsy for histological diagnosis before therapeutic decision was decided. In recent years, percentage of pretreatment histological diagnosis significantly increased in the later ten years than the former during the study period (P=0.008). There was also a significant increase in thoracoscopy/mediastinoscopy/endobronchial ultrasound (E-BUS) biopsy as compared to open biopsy (P=0.029). Survival in Patients with preoperative biopsy for histology had significantly higher stage lesions (P<0.001) and higher grade malignancy (P<0.001), thus a significantly lower complete resection rate (P<0.001) and therefore a significantly worse survival than those without preoperative biopsy (P=0.001). In the biopsied 336 patients, those who received upfront surgery had significantly better survival than those received surgery after induction therapy (P=0.001). In stage III and IVa diseases, the R0 resection rate after induction therapies increased significantly as compared to the surgery upfront cases (65.5% vs 46.2%, P=0.025). Tumors downstaged after induction had similar outcomes as those having upfront surgery (92.3% vs 84.2%, P=0.51). However, tumors not downstaged by induction had significantly worse prognosis than those downstaged (P=0.004), and fared even worse than those having definitive chemoradiation without surgery (37.2% vs 62.4%, P=0.216). Conclusion It is crucial to get histological diagnosis for thymoma before surgery or adjuvant treatment and minimally invasive biopsy should be undertaken. Although in our study we could not find the benefit of induction chemotherapy before surgery in survival and recurrence rate, it could increase the R0 resection rate compared with direct surgery in late stage (III and IVa). pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: Chinese refInfo: holdings: @attributes: islocal: N |
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