Primary tumors of the mediastinum

J Surg Oncol. 1999 Feb;70(2):95-9. doi: 10.1002/(sici)1096-9098(199902)70:2<95::aid-jso6>3.0.co;2-8.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Germinoma / therapy
  • Humans
  • Infant
  • Lymphoma / therapy
  • Male
  • Mediastinal Neoplasms / therapy*
  • Middle Aged
  • Neurilemmoma / therapy
  • Retrospective Studies
  • Thymoma / therapy
  • Thymus Neoplasms / therapy