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. 2021 Dec;12(4):830-837.
doi: 10.1007/s13193-021-01430-5. Epub 2021 Sep 7.

Is Hyperthermic Intrathoracic Chemotherapy (HITHOC) Safe and Efficacious in Masaoka-Koga Stage-IVA Thymoma? A Pilot Study

Arvind Kumar  1 , Mohan Venkatesh Pulle  1 , Belal Bin Asaf  1 , Harsh Vardhan Puri  1 , Aparna Kumar  1 , Sukhram Bishnoi  1
Affiliations

Is Hyperthermic Intrathoracic Chemotherapy (HITHOC) Safe and Efficacious in Masaoka-Koga Stage-IVA Thymoma? A Pilot Study

Arvind Kumar et al. Indian J Surg Oncol. 2021 Dec.

Abstract

This study was aimed at evaluating the safety and efficacy of hyperthermic intrathoracic chemotherapy in patients with Masaoka stage IVA thymoma. This is a retrospective comparative analysis between two groups of patients who were operated for Masaoka stage IVA thymoma. One group underwent complete parietal pleurectomy whereas other group received hyperthermic intrathoracic chemotherapy after complete pleurectomy. An analysis of all perioperative variables, complications and survival was carried out. A total of 13 patients had stage IVA disease during the study period. Initial 7 patients (March 2012-March 2015) underwent complete parietal pleurectomy, whereas next 6 patients (April 2015-December 2018) had undergone HITHOC after complete parietal pleurectomy. Both groups are comparable in terms of age, co-morbidities, tumor size and duration of symptoms. The duration of surgery and intra-operative blood loss, postoperative ICU stay, duration of ICD and total hospital stay was similar between two groups. The total number of post-operative complications was higher in HITHOC group (5 vs 2), however non-significant (p = 0.10). The median follow-up duration was 63 months in no HITHOC group and 49.5 months in HITHOC group. There was no peri-operative mortality. The overall survival (P = 0.06) and relapse-free survival (P = 0.36) were not significantly different in the both groups. Hyperthermic intrathoracic chemotherapy is a safe and feasible modality with no added morbidity or mortality. Multi-institutional prospective studies with large number of patients are required to accurately assess survival benefit.

Keywords: HITHOC; Hyperthermic intrathoracic chemotherapy; Masaoka-Koga stage IVA thymoma; Pleurectomy.

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Conflict of interest statement

Competing InterestThe authors declare no competing interests.

Figures

Image 1
Image 1
Kaplan–Meier survival curves (overall survival and relapse-free survival) in HITHOC group vs no HITHOC group
Image 2
Image 2
Flowchart of management of Masaoka-Koga stage IVA in the study population
See this image and copyright information in PMC

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