Hayashi Kazuki, Hanaoka Jun
Department of General Thoracic Surgery, Omi Medical Center, Kusatsu, Shiga, Japan.
Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
Ann Thorac Surg Short Rep. 2024 Feb 6;2(2):207-210. doi: 10.1016/j.atssr.2024.01.002. eCollection 2024 Jun.
Thymic carcinoma, a rare aggressive tumor, necessitates multidisciplinary approaches for optimal prognosis. The role of surgical interventions in stage IVb thymic carcinoma, as classified by the TNM and Masaoka-Koga staging systems, remains controversial; although some patients present with resectable disease, others do not. We report a case with supraclavicular metastasis and sternal invasion. Preoperative chemoradiotherapy, followed by extended thymectomy and thorough lymph node dissection, resulted in more than a decade of postoperative recurrence-free survival. Complete resection, including metastases, is essential for achieving optimal outcomes, underscoring the need for extensive lymph node dissection. Aggressive surgical procedure is recommended for suitably selected patients.
胸腺癌是一种罕见的侵袭性肿瘤,需要多学科方法以获得最佳预后。手术干预在根据TNM和Masaoka-Koga分期系统分类的IVb期胸腺癌中的作用仍存在争议;尽管一些患者表现为可切除疾病,但其他患者则不然。我们报告一例伴有锁骨上转移和胸骨侵犯的病例。术前放化疗,随后进行扩大胸腺切除术和彻底的淋巴结清扫,术后实现了超过十年的无复发生存。包括转移灶在内的完整切除对于实现最佳结果至关重要,这突出了广泛淋巴结清扫的必要性。对于适当选择的患者,建议采取积极的手术方法。