Prognostic Factors for Cure, Recurrence and Long-Term Survival After Surgical Resection of Thymoma Academic Article uri icon

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abstract

  • INTRODUCTION: To determine long-term outcome and risk factors for recurrence after thymectomy. METHODS: Patients who underwent thymectomy (n = 262) for a thymic tumor (1986-2010) were identified from a prospective database. Patients were classified according to World Helath Organization (WHO) histologic classification, Masaoka staging system, and completeness of resection. Risk factors for recurrence: WHO histology, tumor size, Masaoka stage and completeness of resection were analyzed. RESULTS: Of 262 patients, 51% were female, median age was 55 years, and 39% had myasthenia gravis. Median follow-up was 7.5 years, median tumor size was 5.4 cm, and Masaoka stage distribution was: I (25%), II (47%), III (17%), IV (4%), and (7%) not classified. Of 200 patients classified under the WHO system, there were (7%) type A, (22%) type AB, and (71%) type B; 83% had complete resection. One-hundred and sixty-nine patients received adjuvant radiotherapy, eight adjuvant chemoradiotherapy and 14 neoadjuvant chemoradiotherapy. Overall survival was 95% at 5 years, 91% at 10 years and 91% at 15 years. Recurrence occurred in 12 patients and disease-related death in four patients. Five patients underwent re-resection for recurrence with survival of 2-15 years. Only Masaoka stage and tumor size were associated with statistically significant risk of recurrence on multivariate analysis. CONCLUSION: Resectable thymoma is associated with excellent prognosis. Aggressive resection of recurrent disease yielded excellent long-term results. Higher Masaoka stage is associated with a greater chance of incomplete resection. Higher Masaoka stage and increasing tumor size are independent factors associated with recurrence.

authors

  • Safieddine, Najib
  • Liu, Geoffrey
  • Cuningham, Kris
  • Ming, Tsao
  • Hwang, David
  • Brade, Anthony
  • Bezjak, Andrea
  • Fischer, Stefan
  • Xu, Wei
  • Azad, Sassan
  • Cypel, Marcelo
  • Darling, Gail
  • Yasufuku, Kazu
  • Pierre, Andrew
  • de Perrot, Marc
  • Waddell, Tom
  • Keshavjee, Shafique

publication date

  • July 2014

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