An exploratory study of CT-guided percutaneous radiofrequency ablation for stage I thymoma

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Abstract

Background

Thymoma is a rare tumor that originates from thymic epithelial cells and is usually associated with myasthenia gravis. Radiofrequency ablation (RFA) is a minimally invasive and curative treatment for other tumors, but RFA has not been used for the early treatment of thymoma.

Methods

The current study included 13 patients with stage I thymoma who were not candidates for surgical resection or video-assisted thoracoscopic surgery (VATS). All patients underwent first-line CT-guided percutaneous RFA. The feasibility and therapeutic effects of the intervention were thoroughly documented.

Results

All tumors were completely ablated (13 / 13, 100%). During follow-up (median 80.5 months, range, 64.6–116.9 months), only 1 of the 13 patients had recurrence of thymoma (1 / 13, 7.7%) at 35.5 months after the initial ablation. There were no surgery-related deaths after RFA treatment. The most common complications were fever (13 / 13, 100%) and pain (13 / 13, 100%). There was only one patient who occurred severe puncture-related bleeding during the procedure that needed blood transfusion and intravascular embolization of the punctured-injured vessel.

Conclusion

CT-guided percutaneous RFA for treatment of stage I thymoma is associated with minor trauma, few complications and good treatment outcomes.

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Most cited references 18

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Malignant thymoma in the United States: demographic patterns in incidence and associations with subsequent malignancies.

Eric Engels, Ruth Pfeiffer (2003)

The cause of thymoma is unknown. No population-based study has described demographic patterns of thymoma incidence. Previous reports have linked thymoma with diverse subsequent malignancies, but these associations are uncertain. We used Surveillance, Epidemiology and End Results (SEER) data to study the incidence of malignant thymoma by sex, age and race in the United States (1973-1998). Incidence was modeled with joinpoint regression (for age) and Poisson regression. We also used SEER data to compare malignancies following thymoma diagnosis with those expected from general population rates, calculating the standardized incidence ratio (SIR, observed/expected cases) to measure risk. The overall incidence of malignant thymoma was 0.15 per 100000 person-years (849 cases). Thymoma incidence increased into the 8th decade of age and then decreased. Incidence was higher in males than females (p=0.007) and was highest among Asians/Pacific Islanders (0.49 per 100000 person-years). Following thymoma, there were 66 malignancies (SIR 1.5, 95%CI 1.2-1.9). The most notable excess risk for subsequent malignancy was for non-Hodgkin's lymphoma (B immunophenotype) where the SIR was 4.7 (95%CI 1.9-9.6, 7 cases). There were also excess digestive system cancers (SIR 1.8, 95%CI 1.1-2.9) and soft tissue sarcomas (SIR 11.1, 1.3-40.1). No other cancers were increased after thymoma. In conclusion, malignant thymoma is extremely rare. The peak in late adulthood deserves further study. Variation in incidence by race suggests a role for genetic factors. Our study did not demonstrate broadly increased risk for malignancies following thymoma. Copyright 2003 Wiley-Liss, Inc.

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Follow-up study of thymomas with special reference to their clinical stages

Akira Masaoka, Yasumasa Monden, Kazuya Nakahara … (1981)

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Thymoma and thymic carcinomas.

Marta Scorsetti, Francesco Leo, Annalisa Trama … (2016)

Thymomas (Ts) and thymic carcinomas (TCs) are rare tumours of the mediastinum with an incidence rate of 1.7/million per year in Europe. Histological classification is based on rate of non-malignant-appearing thymic epithelial cells and proportions of lymphocytes (A, AB, B1, B2, B3, and C), while staging system concerns localisation of the involved areas. Surgery is the mainstay of treatment with a 10-year survival of 80%, 78%, 75%, and 42% for stages I, II, III and IV, respectively, with an R0 resection. Radiotherapy has a role in selected cases (stage III patients or R1-2 residual) and platinum-based chemotherapy remains the standard of care for patients with advanced disease. A multimodality approach would be advisable when surgery is not recommended. Since molecular aberrations are poorly understood and few responses are reported, targeted therapies are yet being studied. In this review, we describe key aspects of clinical management for Ts and TCs.

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Author and article information

Contributors

Jun Dong: dongjun1@sysucc.org.cn

Shaofei Yuan: qingzhoude1@hotmail.com

Boyang Chang: changby3@mail.sysu.edu.cn

Jinsheng Huang: huangjinsh@sysucc.org.cn

Xiaojing Geng: 654266759@qq.com

Xiuyu Cai: caixiy@sysucc.org.cn

Pili Hu: hupl@sysucc.org.cn

Bei Zhang: zhangb@sysucc.org.cn

Liangping Xia: xialp@sysucc.org.cn

Peihong Wu: 862087343272 , wuph@sysucc.org.cn

Journal

Journal ID (nlm-ta): Cancer Imaging

Journal ID (iso-abbrev): Cancer Imaging

Title: Cancer Imaging

Publisher: BioMed Central (London )

ISSN (Print): 1740-5025

ISSN (Electronic): 1470-7330

Publication date (Electronic): 2 December 2019

Publication date PMC-release: 2 December 2019

Publication date Collection: 2019

Volume: 19

Electronic Location Identifier: 80

Affiliations

[1 ]ISNI 0000 0004 1803 6191, GRID grid.488530.2, Department of Integrated Therapy in Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, , Sun Yat-sen University Cancer Center, ; Guangzhou, 510060 People’s Republic of China

[2 ]GRID grid.452885.6, Department of Oncology, , The Third Affiliated Hospital of Wenzhou Medical University, ; Wansong Road, Ruian, 108 China

[3 ]ISNI 0000 0004 1762 1794, GRID grid.412558.f, Department of Vascular Interventional Radiology, , the Third Affiliated Hospital of Sun Yat-sen University, ; Guangzhou, 510630 People’s Republic of China

[4 ]GRID grid.452859.7, Department of Geriatric Medicine, , the Fifth Affiliated Hospital of Sun Yat-sen University, ; Guangzhou, 510630 People’s Republic of China

[5 ]ISNI 0000 0004 1803 6191, GRID grid.488530.2, Department of Medical Imaging & Image Guided Therapy, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, , Sun Yat-sen University Cancer Center, ; Guangzhou, 510060 People’s Republic of China

Article

Publisher ID: 267

DOI: 10.1186/s40644-019-0267-8

PMC ID: 6889348

PubMed ID: 31791411

SO-VID: 394283b3-db37-4fbc-9d07-03fc35124d06

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 7 January 2019

Date accepted : 22 November 2019

Funding

Funded by: National Natural Science Foundation of China Young Scientists Fund (CN)

Award ID: 81601581

Award Recipient : Jun Dong

Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;

Award ID: 81600606

Award Recipient : Xiaojing Geng

Custom metadata

Keywords: ct-guided,percutaneous radiofrequency ablation,early stage,thymoma

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Keywords: ct-guided, percutaneous radiofrequency ablation, early stage, thymoma

An exploratory study of CT-guided percutaneous radiofrequency ablation for stage I thymoma

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Abstract

Background

Methods

Results

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Most cited references 18

Malignant thymoma in the United States: demographic patterns in incidence and associations with subsequent malignancies.

Follow-up study of thymomas with special reference to their clinical stages

Thymoma and thymic carcinomas.

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