Intra-Thoracic Chemo-Hyperthermia for pleural recurrence of thymomas

Thymomas are rare thymic epithelial tumors (TETs) with favorable long-term prognosis after R₀ resection surgery: 5-year overall disease-free survival is reported to range from 71% to 92% (1,2). Meanwhile, pleural relapse is a hallmark of thymoma (75% of recurrences) (3). Re-resection is a major predictor of favorable outcome in this setting and is recommend by the European Society for Medical Oncology (ESMO) and the National Comprehensive Cancer Network (NCCN). However, there is still no formal consensus on the surgical practice. Some authors advocate debulking surgery, complete re-resection, or extra pleural pneumonectomy (EPP) in selected patients associated with variable morbidity and mortality. Given indolent progression and specific localization of those recurrence, some authors advocate a new concept of radical cytoreductive surgery associated with Intra-Thoracic Chemo-Hyperthermia (ITCH) based on previous studies realized in mesothelioma.