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32IN NON-SURGICAL TREATMENT
Thymoma involvement pleurectomy or even extrapleural pneumonectomy have been proposed with promising results. Incomplete resection is usually associated with a reduced survival and should therefore be avoided whenever possible. In these cases, clipping of the residual may be helpful for subsequent radiation therapy. Surgery has also a role in the event of a recurrence. Surgical resection of the recurrence has been found to be beneficial for long term survival. Standardization of the surgical procedures and optimal handling of the surgical specimen are crucial. In this respect, a great deal of work is being done by the leading thymic ESTS organizations (European Society of Thoracic Surgeons thymic working group, International Thymic Malignancies Interest Group ITMIG, Japanese Association for Research in Thymoma JART) to provide a uniform set of definitions in the management of thymomas. In conclusion, surgery remains the mainstay in the treatment of thymomas. The surgeon should be experienced in the resection of intrathoracic structures, including vascular procedures. Optimal results may only be obtained following a close cooperation with medical oncologists, radiation oncologists and pathologists in dedicated international thymic working groups. Disclosure: The author has declared no conflicts of interest.
S19 32IN NON-SURGICAL TREATMENT G. Daugaard Department of Oncology 5073, The Finsen Center, Copenhagen, Denmark Thymomas are malignant in nature, but often behave indolent. The prognosis for untreated thymomas has not been well studied. Around 5% will have metastatic disease at diagnosis and 15% will develop metastatic disease during follow-up. The most important prognostic factor is probably tumor stage and current treatment strategies are based on this. Due to the small number of patients with thymoma, treatment data from prospective randomized trials is lacking. Surgery is the primary treatment, especially in stage I and II disease. Identification of patients at high risk of local recurrence who require postoperative radiation is controversial. How treatment should be combined in stage III patients is not clear. Chemotherapy is offered to patients with advanced thymoma but data concerning which regimen to use, rest on small phase II studies. The highest response rates (around 75%) have been obtained with a combination of cisplatin and doxorubicin or etoposide. A better understanding of the molecular characteristics of thymoma could lead to new treatment suggestions. International collaboration is highly needed in this disease in order to get a better definition of optimal treatment. Disclosure: The author has declared no conflicts of interest.
S19 32IN NON-SURGICAL TREATMENT G. Daugaard Department of Oncology 5073, The Finsen Center, Copenhagen, Denmark Thymomas are malignant in nature, but often behave indolent. The prognosis for untreated thymomas has not been well studied. Around 5% will have metastatic disease at diagnosis and 15% will develop metastatic disease during follow-up. The most important prognostic factor is probably tumor stage and current treatment strategies are based on this. Due to the small number of patients with thymoma, treatment data from prospective randomized trials is lacking. Surgery is the primary treatment, especially in stage I and II disease. Identification of patients at high risk of local recurrence who require postoperative radiation is controversial. How treatment should be combined in stage III patients is not clear. Chemotherapy is offered to patients with advanced thymoma but data concerning which regimen to use, rest on small phase II studies. The highest response rates (around 75%) have been obtained with a combination of cisplatin and doxorubicin or etoposide. A better understanding of the molecular characteristics of thymoma could lead to new treatment suggestions. International collaboration is highly needed in this disease in order to get a better definition of optimal treatment. Disclosure: The author has declared no conflicts of interest.