Evaluation of surgical treatment for primary malignant mediastinal tumors

Abstract

Surgical treatment for primary malignant mediastinal tumors was assessed based on our experience with 36 patients from January 1976 to December 1995.
Preoperative needle biopsies and intraoperative biopsies were performed on 16 patients and 20 patients, respectively. The subtypes and cases : 11 invasive thymomas, 9 malignant germ cell tumors, 4 malignant lymphomas, 4 undifferentiated carcinomas and 8 others. Thirty-five patients underwent surgical resection, 13 of whom underwent complete resection. Nine combined resections were all complete resections. The overall 5 year and 10 year survival rates were 56.5% and 46.0% in all primary mediastinal malignant tumors (n=36), 100% and 70.0 % for complete resection which were significantly higher than 32.7% and 32.7% for incomplete resection. Radiotherapy, chemotherapy and preoperative therapy were performed on 20 patients, 14 patients and 2 patients, respectively.
Complete resection was the superior treatment for primary malignant mediastinal tumors except malignant lymphoma. But currently the complete resection rate (36.1%) is low, especially for combined resection. To further improve the prognosis for patients with primary malignant mediastinal tumors, early detection and histological diagnosis are needed, and multiple therapeutic strategies considering histological subtypes are essential.