Background: The treatment options for Masaoka stage III thymic epithelial tumors are diverse, mainly because the lesions infiltrate the neighboring organs, major vascular structures, with different scopes, extents, and manners. Surgical treatment is the main treatment for the patient in this stage. However, for minimally invasive or open surgery, the current controversy remains large. This study aimed to investigate the feasibility and indications of minimally invasive resection in the treatment of stage III thymic tumors.
Methods: Twenty-six patients with Masaoka stage III thymic tumors who underwent surgery were enrolled in the study. Among them, group A with 8 patients underwent thoracoscopic resection and group B with 18 patients (including one open-converted patient) underwent semi-sternotomy or full-sternotomy resection. The groups were compared with each other in terms of the characteristics of patients, tumors, and perioperative period.
Results: There were no significant differences in patients' characteristics, WHO classification, and complications between the two groups (P>0.05), but the tumors in group B were significantly larger than those in group A (P<0.05). In group B, the lesions infiltrated the superior vena cava and the phrenic nerve more frequently than that of group A (P<0.05). There was no significant difference between the two groups in the involvement of left innominate vein, pericardium, and lung (P>0.05). Tumor size, the involvement of superior vena cava and phrenic nerve were important factors in the determination of minimally invasive surgery for Masaoka stage III thymic tumor (P<0.05).
Conclusions: For Masaoka stage III thymic tumors, neighboring organs involved were noted to be important factors in successful minimally invasive tumor resection. Tumor size and involvement of phrenic nerve and superior vena cava were found to be the variables that hindered successful video-assisted thoracoscopy (VATS) resection. Thus, minimally invasive resection is acceptable in the treatment of selected cases of Masaoka stage III thymic tumors.
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http://dx.doi.org/10.21037/tcr.2019.06.02 | DOI Listing |
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Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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View Article and Find Full Text PDFInvest New Drugs
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Center for Biomedical Sciences, Wakayama Medical University, Wakayama, Japan.
The impact of clinical stage on the effectiveness of osimertinib for epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC) remains unexamined. We investigated osimertinib therapeutic efficacy variation between stage IVA or lower and stage IVB EGFR mutation-positive lung cancers, focusing on differences in pretreatment co-occurring genetic alterations in circulating tumor DNA. This was a secondary analysis of the ELUCIDATOR study, a multicenter prospective observational study in Japan that assessed the mechanisms underlying resistance to osimertinib as a first-line treatment for advanced NSCLC with EGFR mutations.
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View Article and Find Full Text PDFPsychooncology
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Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Background: Parents with advanced cancer and their partners are more likely to experience psychological distress than their counterparts without minor children. Greater relationship functioning may support parents in distress.
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Arch Dis Child Fetal Neonatal Ed
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NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, New South Wales, Australia.
Objective: Large-scale mortality trials require reliable secondary assessments of impairment. We compared the Ages and Stages Questionnaire (ASQ-3), a screening tool self-administered by parents, in classifying impairment using the 'gold standard' Bayley Scales of Infant Development (Bayley-III), a diagnostic tool administered by trained assessors.
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