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Ann Thorac Surg 2003;76:653
© 2003 The Society of Thoracic Surgeons

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Correspondence

Reply to the editor

^a Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Sakyo-ku, Kyoto 606-8507, Japan

e-mail: wadah{at}kuhp.kyoto-u.ac.jp

We thank Dr Kumar and colleagues for their interest in our article [1] and appreciate the opportunity to respond. We appreciate their favorable comments on our novel technique, the Hemi-Plastron Window technique.

We congratulate Dr Kumar and others for their successful application of alpha 2a-interferon to mediastinal epithelioid hemangioendothelioma[2]. There were two simple reasons why we did not use alpha 2a-interferon in the present case. First, no preoperative diagnosis was made. Because the tumor was surrounded by large vessels, preoperative transcutaneous needle biopsy was not performed. Second, we were not aware of the potent effects of alpha 2a-interferon on tumors of vascular origin at that time.

As Dr Kumar mentions, a significant change in the therapeutic tactics of intrathoracic tumors of vascular origin is available. Alpha 2a-interferon chemotherapy should be considered first in unresectable, extensive, or invasive tumors of vascular origin. Subsequently surgical resection can be performed according to the response. Conversely, simple surgical resection may be indicated for small, limited lesions. Possible side effects of alpha 2a-interferon are not completely known, even though low toxicity in a long-term use has been reported [3].

Further studies are required to elucidate the risk-benefit ratio of alpha 2a-interferon in intrathoracic tumors of vascular origin.

References

1. Isowa N., Hasegawa S., Mino M., Morimoto K., Wada H. Mediastinal epithelioid hemangioendothelioma resected by Hemi-Plastron Window technique. Ann Thorac Surg 2002;74:567-569.[Abstract/Free Full Text]
2. Kumar P., Judson I., Nicholson A., Ladas G. Mediastinal haemangioma: successful treatment by alpha-2a interferon and post chemotherapy resection. J Thorac Cardiovasc Surg 2002;124:404-406.[Free Full Text]
3. Cascinelli N., Belli F., MacKie R.M., Santinami M., Bufalino R., Morabito A. Effect of long-term adjuvant therapy with interferon alpha-2a in patients with regional node metastases from cutaneous melanoma: a randomised trial. Lancet 2001;358(9285):866-869.[Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Seiki Hasegawa Hiromi Wada Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hasegawa, S. Articles by Wada, H. Search for Related Content PubMed Articles by Hasegawa, S. Articles by Wada, H. Related Collections Chest wall