Single-center evaluation of prognostic factors for thymoma treated by surgery: a retrospective study

Abstract

Background This study aimed to retrospectively evaluate the clinical, pathological, and treatment-related factors associated with survival in patients with surgically treated thymomas. Methods Sixty patients with thymomas who underwent treatment at our institution between 2004 and 2015 were included. Survival analysis was performed based on curves that were obtained using the Kaplan–Meier method. The Wilcoxon test was used for all comparisons, and p < 0.05 was considered statistically significant. Results Forty-seven, four, three, four, and two patients presented tumor stages I, II, III, IVa, and IVb (according to the Masaoka classification), respectively, while six, 14, 11, 22, and seven patients had type A, AB, B1, B2, and B3 thymomas, respectively. Furthermore, 53 and eight patients underwent complete resection and required additional resection of adjacent organs, respectively, and no patients died from surgery-related complications. The five-year survival and recurrence-free survival (RFS) rates were 96 and 86%, respectively. The five-year survival rate for all stages was 100% except for those with stage IVb tumors (Masaoka classification); the survival rate for those patients was 0%. Separately, the five-year RFS rates for tumor stages I, II, III, IVa, and IVb were 100, 91, 91, 81, and 71%, respectively. Finally, the five-year survival rates in cases with complete and incomplete resections were 100 and 71%, respectively, indicating that the latter group had a significantly poorer prognosis (p < 0.001). Conclusions These findings suggest that complete resection and the Masaoka pathological stage are significant predictors of prognosis in patients with thymomas. Surgery should aim to achieve complete resection; however, advanced cases may require multimodality therapy.

Prognostic factors and genetic markers in thymic epithelial tumors: A narrative review

“…According to some studies, myasthenia gravis does not affect survival in patients with TET 14,15,25 . On the other hand, there are studies suggesting that the presence of myasthenia gravis has a positive impact on survival 3 .…”

“…There is robust and reproducible data derived from the available studies demonstrating that an advanced Masaoka‐Koga stage is associated with a worst prognosis. 24 , 25 , 27 , 28 , 29 , 30 In one study, the 5‐year OS rates of stage II, III, and IV were 88, 100, and 80%, respectively and 5‐year DFS rates were 88, 75, and 55%, respectively. 27 In another study, the 5‐year survival rates were 100, 100, 80 and 0%, respectively.…”

“…18,24 According to some studies, myasthenia gravis does not affect survival in patients with TET. 14,15,25 On the other hand, there are studies suggesting that the presence of myasthenia gravis has a positive impact on survival. 3 A possible explanation according to Wilkins et al is the fact that MG symptoms lead to the diagnosis of thymomas at an earlier stage.…”

“…Extended thymectomy has previously been reported to provide better survival than partial thymectomy (thymomectomy). 17,25,44 In a study by Kamata et al, the 5-year OS rates for thymectomy and extended thymectomy were 100 and 95%, respectively, and recurrence-free survival rates 100 and 80%, respectively. However, the extent of resection is not clearly mentioned in the various series, making comparison difficult.…”

CT-Based Radiomics Nomogram for Differentiation of Anterior Mediastinal Thymic Cyst From Thymic Epithelial Tumor

“…The clinical treatment of thymic cysts and thymoma differs. In general, asymptomatic thymic cysts can be treated without surgical treatment, but early surgical resection is highly recommended if thymoma is definitively identified (4)(5)(6). Therefore, the correct preoperative diagnosis of thymic cysts and thymoma is important.…”