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Primary tumors of the mediastinum
Author(s) -
Whooley Brian P.,
Urschel John D.,
Antkowiak Joseph G.,
Takita Hiroshi
Publication year - 1999
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(199902)70:2<95::aid-jso6>3.0.co;2-8
Subject(s) - medicine , radiation therapy , thymoma , germ cell tumors , mediastinum , primary tumor , chemotherapy , retrospective cohort study , surgery , multivariate analysis , radiology , metastasis , cancer
Background and Objectives Diagnostic and therapeutic approaches to mediastinal tumors have changed over the past three decades. We reviewed our recent experience with these tumors and assessed the role of a multidisciplinary treatment approach. Methods A retrospective review of 124 patients with primary mediastinal tumors over a 25‐year period. Results Median age was 35 years. Symptoms were present in 86 of 124 (69%) patients. One hundred and eleven of 124 (90%) tumors were malignant. Distant metastases were present at diagnosis in 14 of 124 (11%) patients. The most common tumor was thymoma (38/124, 31%), followed by germ‐cell tumor (29/124, 23%), lymphoma (24/124, 19%), and neurogenic tumors (15/124, 12%). Seventy‐four of 124 (60%) patients underwent resection, 88 (71%) received chemotherapy, and 97 (78%) received radiation therapy. Tumor recurrence occurred in 52% (47/91) of patients who initially had a complete resection or response to treatment. Median time to recurrence was 10 months. Overall median survival was 44 months. Metastatic disease at presentation ( P = 0.02) and tumor recurrence ( P = 0.00001) were the only significant independent predictors of survival on multivariate analysis. Conclusions Malignant primary mediastinal tumors often require multimodality treatment. Despite improvements in survival with multimodality treatment, death from recurrent disease remains a problem. J. Surg. Oncol. 1999;70:95–99. © 1999 Wiley‐Liss, Inc.