Thymectomy With and Without Povidone-iodine Pleural Lavage in Stage IVA Thymic Malignancies

Who can take part

• Eastern Cooperative Oncology Group - PS 0 or 1
• Patients with a histologic diagnosis of thymic epithelial tumor (thymoma WHO type A, AB, B1, B2, B3; or thymic carcinoma) who in the opinion of the attending thoracic surgeon can technically receive a macroscopic complete resection of pleural nodules. This histologic diagnosis can be obtained either preoperatively, or based on frozen section intra-operatively
• Signed informed consent form
• Completely resectable burden of disease
• No evidence of distant organ metastasis except resectable pulmonary parenchymal nodules and intrathoracic lymph node metastasis as evidenced by CT chest, physical examination, and any other indicated studies
• Medically suitability for resection as determined by the operating surgeon
• Women of childbearing potential (WOCBP) must have a negative urinary pregnancy test pre-operatively

Who cannot take part

• Pulmonary nodules or visceral nodules requiring pulmonary resection sacrificing more than half of ipsilateral lung parenchyma
• Patients with active invasive cancers, other than thymoma, that requires treatment, except non-melanomatous skin cancer, superficial bladder cancer or cervical cancer and early stage prostate cancer
• Hyperthyroidism or Radioisotope treatment for thyroid disease
• Radiographic evidence of disease beyond the primary site and pleural space
• History of pulmonary resection more than lobectomy. (regardless of laterality)
• Patients with iodine allergy
• Patients who have severe liver disease including cirrhosis, grade III-IV elevations in liver function studies, or bilirubin in excess of 1.5 mg/decilitre
• If frozen section reveals a diagnosis other than thymoma or thymic carcinoma, the patient will be removed from protocol and the providone-iodine lavage will not be performed
• Pregnant or lactating patients