{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:30:56Z","timestamp":1762432256241,"version":"3.37.3"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Stage IVa thymic malignancy has limited treatments. This study evaluated whether hyperthermic intraoperative chemotherapy\u00a0(HIOC) after radical resection of Stage IVa thymic malignancy improves survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients who underwent resection, with or without HIOC, for Stage IVa thymic malignancy at a single center from 1990 to 2021 were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010four patients were identified; 22 surgery\u2010only versus 12 surgery and HIOC (60\u2009min\u00a0cisplatin regimen 175\u2009mg\/m<jats:sup>2<\/jats:sup>). Demographics and comorbidities were similar between groups. Three patients in each group were carcinomas; remainder were thymomas. Thirty\u2010two patients underwent attempted macroscopic complete resection; 22 operations succeeded, 68.8%. Significant complications were similar between groups, 18.2% surgery\u2010only versus 25.0% HIOC, <jats:italic>p<\/jats:italic>\u2009=\u20090.68. Median time to recurrence trended longer for HIOC patients (42.9 vs. 32.9 months in surgery\u2010only, <jats:italic>p<\/jats:italic>\u2009=\u20090.77). Overall survival, 5\u2010year, was similar (75.8% HIOC vs. 76.2% surgery\u2010only, <jats:italic>p<\/jats:italic>\u2009=\u20090.91). On stratified analysis, thymoma patients with macroscopic complete resection and HIOC experienced similar 5\u2010year Overall (80.0% vs. 100.0% surgery\u2010only, <jats:italic>p<\/jats:italic>\u2009=\u20090.157) but longer trending 5\u2010year disease\u2010free (85.7% vs. 40.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.18) and 5\u2010year locoregional recurrence\u2010free survival (85.7% vs. 68.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.75).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This retrospective cohort study treating Stage IVa thymic malignancy with radical pleurectomy, with or without HIOC, found addition of HIOC\u2010signaled delayed recurrence and improved disease\u2010free survival.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27150","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T13:01:04Z","timestamp":1669899664000},"page":"734-740","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Hyperthermic intraoperative chemotherapy (HIOC) for Stage IVa thymic malignancy may improve 5\u2010year disease\u2010free survival"],"prefix":"10.1002","volume":"127","author":[{"given":"Daniel P.","family":"Dolan","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2750-0924","authenticated-orcid":false,"given":"Emily","family":"Polhemus","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery Brigham and Women's Hospital Boston Massachusetts 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