Impact of Lymph Node Dissection on Thymic Malignancies: Multi-Institutional Propensity Score Matched Analysis

Hwang, Yoohwa; Kang, Chang Hyun; Park, Samina; Lee, Hyun Joo; Park, In Kyu; Kim, Young Tae; Lee, Geun Dong; Kim, Hyeong Ryul; Choi, Se Hoon; Kim, Yong Hee; Kim, Dong Kwan; Park, Seung-Il; Shin, Sumin; Cho, Jong Ho; Kim, Hong Kwan; Choi, Yong Soo; Zo, Jae Ill; Shim, Young Mog; Lee, Chang Young; Lee, Jin Gu; Kim, Dae Joon; Paik, Hyo Chae; Chung, Kwansoo

doi:10.1016/j.jtho.2018.08.2026

Cited by 30 publications

(43 citation statements)

References 22 publications

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“…We thank Yu et al for their interest in our study and questions. 1 They argued the high rate of lymph node metastasis in thymoma, with an incidence of 6.7% in our study. In their experience, Yu et al 1 could not find any metastasis in any of 417 patients with thymoma.…”

Section: To the Editorsupporting

confidence: 48%

“…6,7 Meanwhile, there were some studies that catered to the recommendation and began claiming that the rates of lymphogenous metastasis in thymoma were 1.2% to 2.3%. 8,9 But in the latest article of Hwang et al, 1 the rate reached up to 6.7%. Which factor could have led to such a "marked shift"?…”

Section: The Real Situation Of Lymph Node Metastases In Thymomamentioning

confidence: 96%

“…To the Editor: With interest, we read the article by Hwang et al 1 The authors should be praised for analyzing a relatively large group of patients with thymic malignancies. Furthermore, they made comparisons of the 10-year rate of freedom from recurrence in thymoma and thymic carcinoma after propensity score matching.…”

Section: The Real Situation Of Lymph Node Metastases In Thymomamentioning

confidence: 99%

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The Real Situation of Lymph Node Metastases in Thymoma

2019

Journal of Thoracic Oncology

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be adopted in the standard treatment setting. We agree that it warrants further investigation in a larger prospective study. Based on a cell line study conducted by Luo et al. 1 , it seems clear that WES can comprehensively analyze the DDR mutational status and predict the correlation to the TMB in small cell lung cancer cell lines. However, a potential bias which could be lead from the difference between cell line and the human tissue, and the different time point of the cell line sample acquisition, such as different stage, should be considered for the data interpretation. At the end of the day, clinical utility of WEScalculated DDR outcomes should be warranted from the further researches.

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Section: To the Editorsupporting

confidence: 48%

Section: The Real Situation Of Lymph Node Metastases In Thymomamentioning

confidence: 96%

Section: The Real Situation Of Lymph Node Metastases In Thymomamentioning

confidence: 99%

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The Real Situation of Lymph Node Metastases in Thymoma

2019

Journal of Thoracic Oncology

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“…The actual incidence of lymph node metastasis has not been well established. Historically, the prevalence of lymph nodes involvement has been described ranging from 1.8% to 5.1% in thymomas and from 20% to 33.5% in thymic carcinomas and NETs, but these rates could be underestimated because lymphadenectomy is rarely performed by most institutions [91][92][93][94][95] . Two factors have been described to explain lymph node metastasis, namely WHO subtype and tumor size, being both closely related to the biologic aggressiveness of the tumor [96,97] .…”

Section: Lymphadenectomymentioning

confidence: 99%

Standardized definitions and concepts of radicality during minimally invasive thymoma resection

Iaco¹,

Brascia²,

Geronimo³

et al. 2020

Mini-invasive Surg

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Radical thymectomy is the gold standard treatment for thymoma; in particular, completeness of surgical resection of a well-encapsulated thymoma and adequate margins are considered the most important prognostic factors. According to the International Thymic Malignancy Interest Group instructions, in fact, the thymus should be resected en bloc with its upper cervical poles and the surrounding mediastinal fat and through a no-touch surgical technique. For years, the open approaches have been considered the gold standard treatment for thymic masses, because of technical advantages and proved good oncological results. When applied to properly chosen patients on the basis of the tumor stage, dimension, and histology, minimally invasive approaches could be as effective as open ones in terms of long-term outcomes. To accomplish a minimally invasive thymoma resection, several minimally invasive techniques (transcervical, subxiphoid, thoracoscopic, and robotic) have been described, each presenting advantages and drawbacks. Moreover, when dealing with early stage neoplasms, many authors have proposed to perform the thymomectomy alone, not involving the rest of the thymic gland, but evidence is still imprecise and vague, and some studies have described a higher rate of local recurrence when using this technique. Finally, many studies suggest that surgeons with expertise in minimally invasive lymphadenectomy for lung cancer may easily endorse the idea of nodal dissection, to be performed at least in advanced thymomas involving neighboring structures, large masses, and thymic carcinomas.

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“…To the Editor: Much-needed consensus recommendations on the use of radiation therapy for malignant pleural mesothelioma (MPM) were recently provided by an expert panel. 1 The authors focused their efforts to standardize/optimize radical treatments, with adjuvant radiotherapy delivered before or after extrapleural pneumonectomy or after pleurectomy/decortication. However, new studies are opening the way to reconsider a more aggressive approach in the palliative setting in view of preliminary evidence on increasing patients' overall survival.…”

Section: The "Radical" Palliation That Increases Survival In Malignanmentioning

Impact of Lymph Node Dissection on Thymic Malignancies: Multi-Institutional Propensity Score Matched Analysis

Abstract: Lymph node metastasis was a significant prognostic factor in thymic malignancies. Although LND did not improve long-term outcomes in thymic malignancies, LND played a role in accurate staging, and improved prediction of prognosis.

Cited by 30 publications

References 22 publications

The Real Situation of Lymph Node Metastases in Thymoma

The Real Situation of Lymph Node Metastases in Thymoma

Standardized definitions and concepts of radicality during minimally invasive thymoma resection

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