Title: Particularités De La Chirurgie Des Tumeurs Médiastinales Après Chimiothérapie D'induction: Surgical Particularities In Mediastinal Tumors After Induction Chemotherapy
Authors: I.ARRAMACH,;M.TACHAOUINE ; K.EL AMRAOUI ; K.NDANGI ; H.HARMOUCHI,; M.LAKRANBI,; Y.OUADNOUNI,; M.SMAHI, .
Volume: 10
Issue: 6
Pages: 79-84
Publication Date: 2026/06/28
Abstract:
Introduction: Mediastinal masses represent a group of rare tumors, often asymptomatic, yet their discovery raises significant diagnostic and therapeutic challenges. Material and Method: Our study aligns with this objective, aiming to analyze the specific features of surgical management of mediastinal tumors following chemotherapy, with a focus on the technical adaptations required after medical treatment. This is a retrospective study conducted in the Department of Thoracic Surgery at Hassan II University Hospital in Fez, over a sixteen-year period from January 2009 to August 2025. Results: The median patient age was 39.7 years, with a masculine predominance. Clinically, patients presented with varied symptoms. Chest pain and dyspnea were the most frequent (57). Paraclinical evaluation was systematic and tailored to each case. All patients underwent comprehensive imaging workup: chest X-ray, thoracic CT scan, PET scan, brain MRI, etc. The diagnosis was confirmed histologically by preoperative biopsy, and it was Thymic epithelial tumors (TETs) in 57%. All patients received induction chemotherapy, tailored to the histological type and tumor progression. In most cases, this led to a significant reduction in tumor volume (average response of 45%). Surgery was performed in all patients, with technical adjustments based on chemotherapy response, tumor location, and invaded structures. The average follow-up was 8 months, with a maximum of 3.5 years. Four patients continued oncological follow-up. Outcomes were variable: clinical and biological stability in some, metabolic or infectious complications in others. In conclusion, this study highlights the specific challenges of mediastinal surgery following chemotherapy. It requires meticulous planning, anticipation of treatment-related complications, and technical adaptation to each case.