AB037. The safety of surgery plus hyperthermic intrathoracic chemotherapy perfusion in patients with IVa thymic epithelial tumors
Original Research

AB037. The safety of surgery plus hyperthermic intrathoracic chemotherapy perfusion in patients with IVa thymic epithelial tumors

Xuefei Zhang, Ning Xu, Teng Mao

Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai, China

Correspondence to: Teng Mao, MD. Department of Thoracic Surgery, Shanghai Chest Hospital, No. 241 West Huaihai Road, Shanghai 200030, China. Email: hippomao@hotmail.com.

Background: In thymic epithelial tumors (TETs) with pleural dissemination, namely stage IVa TETs, hyperthermic intrathoracic chemotherapy perfusion (HITHOC) has been used to augment the effect of local control by surgery. This study aimed to re-examine the safety features surgery plus HITHOC in stage IVa TETs.

Methods: Patients with stage IVa TETs were prospectively enrolled in this study at Shanghai Chest Hospital. Procedure included surgical resection of anterior mediastinal lesion and all visible pleural lesions, followed by HITHOC. Perfusion was performed using 120–150 mg/m2 of cisplatin at a set temperature of 45 Celsius for 60 minutes.

Results: From January 2024 to March 2025, a total of 86 patients were enrolled in this study. All the patients complete this procedure. Thirty-six (41.9%) patients were de novo stage IVa TETs, 21 (24.4%) had concurrent Myasthenia Gravis, 28 (32.6%) patients received minimally invasive surgery, and the median surgery duration was 230 [110–585] minutes. The first 10 patients received a dosage of 150 mg/m2 of cisplatin. One experienced grade 3 hepatotoxicity and the other one experienced grade 4 nephrotoxicity. The followed 76 patients received a dosage of 120 mg/m2 of cisplatin. No cases of grade 3 or higher hepatotoxicity or nephrotoxicity were observed. There was no evidence of myelosuppression associated with HITHOC in any of the patients. The remaining most common postoperative complication was vomiting, which could possibly be related to anesthetic agents. There were no perioperative deaths in these patients.

Conclusions: Surgical resection plus HITHOC with a dosage of 120 mg/m2 of cisplatin showed good safety features. Long-termed oncological outcomes need further follow-up.

Keywords: Thymic epithelial tumor (TET); pleural dissemination; surgical resection; hyperthermic intrathoracic chemotherapy perfusion (HITHOC)

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-25-ab037/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the ethics board of Shanghai Chest Hospital (No. IS24110) and informed consent was obtained from all individual participants.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/med-25-ab037
Cite this abstract as: Zhang X, Xu N, Mao T. AB037. The safety of surgery plus hyperthermic intrathoracic chemotherapy perfusion in patients with IVa thymic epithelial tumors. Mediastinum 2025;9:AB037.

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