Recently, the "Report on the Development of Malignant Tumor Disciplines in China (2020)" (hereinafter referred to as the "Development Report"), edited by the Chinese Anti-Cancer Association, was released, which has important guiding reference significance for promoting the development of cancer diagnosis and treatment in China. Fang Wentao, director of the Department of Thoracic Surgery of Shanghai Chest Hospital, and Mao Teng, director of the mediastinal subspecialty, led the members of the Mediastinal Tumor Professional Committee of the Chinese Anti-Cancer Association and prepared the relevant chapters of the Development Report on the research progress and future development of thymus tumors.
At the same time, China's first "Guidelines for the Diagnosis and Treatment of Thymic Tumors of the Chinese Anti-Cancer Association (CACA)" led by the Chest Hospital has also been completed and will be published soon. As the world's largest mediastinal disease diagnosis and treatment center, Chest Hospital has always maintained a leading domestic and international first-class level in this field, and provided positive contributions to the establishment of a standardized and full-process multidisciplinary diagnosis and treatment system for mediastinal diseases.
Decades of sharpening a sword, leading the way in overcoming complex and incurable mediastinal diseases
There are many categories of mediastinal diseases, the situation is complex, and it is notoriously difficult to diagnose and treat in the field of thoracic surgery. As early as 2004, with profound clinical accumulation, the chest hospital led the creation of the new thymic epithelial tumor classification of the World Health Organization (WHO), and participated in the formulation of the first international TNM staging of thymic tumors. In 2012, the hospital led the establishment of the "China Thymic Tumor Collaboration Group (ChART)", in 2015 established the Thoracic Surgery Mediastinum Subspecialty, and then led the establishment of the CSCO Mediastinal Tumor Expert Committee of the Chinese Clinical Oncology Association and the Mediastinal Tumor Professional Committee of the Chinese Anti-Cancer Association.
Over the years, the hospital has led the member units across the country to carry out research covering all aspects of disease management such as surgical indications, surgical methods, postoperative auxiliary treatment, postoperative follow-up, and new drug research, and is committed to establishing and improving the diagnosis and treatment standards for mediastinal diseases in China. At present, the chest hospital has the world's largest number of clinical cases of mediastinal diseases, and the world's largest number of thymic tumor case banks, with an annual number of thymic tumor cases of more than 600 cases, ranking first in the world.
Applicable to China's national conditions, the diagnosis and treatment of thymoma has broken through the inherent diagnosis and treatment mode
Thymus tumors are the most common of mediastinal tumors, and in the mainland, the actual number of patients of the disease is not low, but there are many controversies about its diagnosis and treatment model. Based on rich clinical resources and several years of dedicated research, Fang Wentao's team for the first time proposed the world's first recurrence prediction model for thymic tumors and its significance for prognosis and long-term management based on the analysis of Chinese groups, providing strong clinical guidance and suggestions for the management mode of thymic tumor patients in mainland China and the world.
In the latest edition of the Development Report, experts have also made new recommendations for thymic tumor screening. In the past, thymic tumors were thought to be a rare tumor, but with the popularity of chest CT, the detection rate of thymic tumors may exceed 100 times that of previous cognition, so special attention needs to be paid to the follow-up of small nodules in the anterior mediastinum. In the upcoming "Guidelines", further in view of the above problems and surgical indications for recurrent tumors, intraoperative lymph node sampling/dissection, preoperative induction therapy mode, recurrence risk model guidance postoperative treatment and follow-up, etc., the diagnosis and treatment suggestions with Chinese characteristics are further given.
In addition, the Development Report also explores hot issues in the future development, such as artificial intelligence-assisted diagnosis, minimally invasive surgical method selection, local advanced induction therapy, advanced targeted and immunotherapy, and clinical research on rare tumors in the mediastinum, leading the future research direction of diagnosis and treatment of thymic tumors and even mediastinal diseases.
Deeply cultivate clinical practice, mediastinal multidisciplinary model to upgrade the medical experience
As the first medical unit in Shanghai to advocate multidisciplinary comprehensive treatment of tumors, the chest hospital will also practice the multidisciplinary joint model (MDT) deep immersion in mediastinal diseases. Diagnosis, treatment, service, and research are integrated, so that patients' sense of medical access continues to upgrade.
The hospital's multidisciplinary team for mediastinal diseases consists of mediastinal surgery, respiratory medicine, radiotherapy and many medical technology departments. Since 2013, the team has insisted on holding monthly mediastinal multidisciplinary discussions, which have been held for nearly 100 sessions so far, relieving more than 400 patients of difficult and stubborn diseases. In 2020, the "Mediastinal Disease Multidisciplinary Clinic" was opened, and then the first materialized operation of the "Mediastinal Disease Integration Ward" in Shanghai was established to effectively connect outpatient and inpatient clinics. So far, the mediastinal multidisciplinary outpatient clinic has treated more than 200 patients.
"Shanghai's experts are fast, accurate and fierce, so that I have taken fewer detours!" Ms. Yan, 26, is young and has a large lump in her chest. She ran to many well-known hospitals across the country, but she could not make a definitive diagnosis, and said that she was lymphoma, which frightened her. In the mediastinal multidisciplinary outpatient clinic of the Chest Hospital, the experts comprehensively evaluated the imaging, clinical and pathological aspects and diagnosed it as a thymus tumor. Through the precise treatment of "thymoplasmectomy + radiotherapy", Ms. Yan returned to a healthy life.
Don't let go of any "bad guys", and don't let the patient suffer a little more. The multidisciplinary team can also distinguish "benign and malignant" in more than ten types of mediastinal diseases in the category, and make accurate diagnoses for patients. There was once a patient who had been put on a "lymphoma" hat, and under the cocoon of the multidisciplinary team, he was diagnosed with "sarcoidosis", and after effective and timely treatment, the patient seemed to be a new life.
Zheng Ning, secretary of the party committee, said: "A sword has been sharpened for decades. Our dedicated research and clinical practice in the field of mediastinal diseases have been exchanged for a 'double harvest' of clinical and research, which can not only bring a healthy future to countless patients in China, but also enable Chinese norms to influence the world." ”
Column Editor-in-Chief: Gu Yong Text Editor: Huang Yangzi
Source: Author: Huang Yangzi
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