AI Article Synopsis
- The study assessed the effectiveness and safety of hyperthermic intrathoracic chemotherapy (HITHOC) as an additional treatment for thymic epithelial tumors, focusing mostly on thymomas.
- A systematic review of 15 studies, including 248 patients, revealed that the combination of HITHOC with cytoreductive surgery had low operative and overall mortality rates (2.42% and 8.32%, respectively) but a significant disease recurrence rate of nearly 26%.
- The findings highlight the potential benefits of HITHOC for thymomas, showcasing its low risks for complications like pneumonia and acute kidney injury, while also indicating the challenge posed by the high recurrence rate for long-term management.
Article Abstract
Introduction: The study was designed to evaluate the efficacy and safety of hyperthermic intrathoracic chemotherapy (HITHOC) as an adjuvant treatment for thymic epithelial tumors, including thymomas and thymic carcinomas.
Methods: A systematic review of PubMed, Embase, and Cochrane Library databases was conducted from inception to July 30, 2024. The analysis included retrospective studies and case series involving patients undergoing cytoreductive surgery combined with HITHOC for thymomas. The treatment effects for binary endpoints were assessed using proportion rates with 95% confidence intervals (CIs). Statistical analyses were performed using R software.
Results: Fifteen studies comprising 248 patients were included. The mean age of patients was 56 years. Thymomas represented 92% of cases, thymic carcinomas 7%, and other thymic neoplasms 1%. Operative mortality was 2.42% (95% CI 1.09-5.28), and overall mortality was 8.32% (95% CI 4.25-15.65). The disease recurrence rate was 25.99% (95% CI 14.04-43.02). The incidence of pneumonia was 1.96% (95% CI 0.45-8.16), and acute kidney injury (AKI) was 2.83% (95% CI 0.94-8.20).
Conclusions: The combination of cytoreductive surgery with HITHOC in patients with thymomas resulted in low operative and overall mortality, as well as low rates of AKI. However, the high recurrence rate presents a challenge for long-term disease control. This study provides the most up-to-date evidence on the safety and efficacy of HITHOC for thymomas, contributing valuable insights for clinical practice.
Trial Registration: International Prospective Register of Systematic Reviews; No.: CRD42024566953; URL: https://www.crd.york.ac.uk/prospero/ .
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