The Effectiveness of Postoperative Radiotherapy in Patients With Completely Resected Thymoma: A Meta-Analysis

Zhou, Dong; Deng, Xu; Liu, Quan‐Xing; Zheng, Hong; Min, Jia-Xin; Dai, Ji‐Gang

doi:10.1016/j.athoracsur.2015.06.034

Cited by 43 publications

(29 citation statements)

References 25 publications

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“…COX regression analysis in our study indicated that Masaoka stage III + IV, not‐R0 resection, and recurrence were independent risk prognostic factors, but older age seemed to be a protective factor for recurrence, which was similar to the study by Li . The role of postoperative radiotherapy for thymomas remains controversial . A previous study pointed out that adjuvant radiotherapy within one month after thymectomy may be helpful in controlling postoperative MG, such as decreasing the possibility of POMC and raising the probability of reaching CSR, but no prognostic benefit for thymoma was found .…”

Section: Discussionsupporting

confidence: 85%

Surgical effect and prognostic factors of myasthenia gravis with thymomas

et al. 2020

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Background: To evaluate the surgical effect and prognostic factors of extended thymectomy for myasthenia gravis (MG) patients with thymomas. Methods: Patients with MG with thymomas who underwent extended thymectomy at Peking University People's Hospital and Beijing Hospital between January 2010 and December 2018 were retrospectively enrolled. Patients were followed up by telephone or outpatient record review . Statistical analyses were performed using SPSS version 19.0. Results: A total of 194 patients were included in this study. According to the Osserman classification, there were 56 type I, 52 type IIa, 67 type IIb, 14 type III, and five type IV. Video-assisted thoracoscopic surgery (VATS) thymectomies were performed in 137 patients, and transthymectomies in 57 patients. The average operation time was 136.6 AE 46.5 minutes, average blood loss was 129.3 AE 287.4 mL, and average postoperative stay was 8.3 AE 7.4 days. A total of 170 patients (87.6%) were successfully followed up. The median follow-up period was 45 months, and the five-year overall survival (OS) rate was 81.9%. Cox regression analysis demonstrated that age, Masaoka stage, and recurrence were prognostic factors of OS. Tumor recurrence tended to occur in patients with Masaoka stage III + IV, and age was a protective factor. A total of 20 patients experienced postoperative myasthenic crisis (POMC). Univariate analysis indicated that presence of bulbar symptoms, surgical procedure, and blood loss were risk factors for POMC, but multivariate analysis only indicated the presence of bulbar symptoms as an independent risk factor. A total of 162 patients were evaluated for post intervention MG status. A total of 55 patients achieved complete stable remission; the overall effective rate was 84.5%. Older patients and those with B-type thymomas had a lower probability of achieving complete stable remission. Efficacy was similar in patients who underwent VATS or the transsternal procedure. Conclusions: Age, Masaoka stage, and recurrence were prognostic factors of OS. Presence of bulbar symptoms was an independent risk factor for POMC. Age and World Health Organization classification influence the postoperative effect of MG. Key pointsSignificant findings of the study Age, Masaoka stage, and recurrence were prognostic factors of OS for MG with thymomas. The presence of bulbar symptoms was an independent risk factor for POMC. Age and World Health Organization classification may influence the postoperative effect of MG. What this study addsOur study had a relatively large sample size of MG patients with thymomas only. We emphasize the analysis of the postoperative effect of MG and overall survival for these patients, which is a complement to previous studies. Transsternal thymectomyPatients were placed in the supine position with the shoulders upward under general anesthesia. A single-lumen tube was used for intubation. Through a complete sternotomy, the sternum was retracted using a retractor. After entering the mediastinum, the thymoma, whole thymus, and all a...

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Section: Discussionsupporting

confidence: 85%

Surgical effect and prognostic factors of myasthenia gravis with thymomas

et al. 2020

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“…The role of adjuvant RT after complete resection in Masaoka stage II disease is controversial (26). Recently, well powered large sized studies showed increase in OS in Masaoka stage II and III thymoma with adjuvant RT (9,26,27). Radiotherapy planning should be established cautiously in adjuvant setting in terms of benefit versus toxicity, since thymomas grow in close proximity to critical organs (28).…”

Section: Discussionmentioning

confidence: 99%

Role of radiotherapy in Masaoka stage II and III thymomas - single center experience

Kıraklı¹,

Erdem²,

Bozkurt³

et al. 2019

Ege Tıp Dergisi

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Aim: Thymomas are rare neoplasms. Complete surgical resection is the cornerstone of the treatment. The role of adjuvant radiotherapy (RT) in Masaoka stage II disease is controversial, but in more advanced stages and the role of radical RT in inoperable cases are clear. This study is conducted to evaluate local control, relapse free survival and overall survival rates in Masaoka stage II and III thymoma patients after adjuvant or radical RT. Materials and Methods: The medical records of thymoma patients who were treated and completed their RT course between January 2010 and August 2016 in a single center were evaluated retrospectively. Results: Twenty-two patients were available for analysis. Treatment planning was adjuvant in 18 patients and radical in 5 patients. Median age at diagnosis was 59 (50-62). Type of resection was R0 in all cases. The adjuvant RT dose was 50 Gy; radical RT dose was 60-66 Gy. The most common acute toxicity was grade 1 pneumonitis which was reported in 9 patients (39%). Grade 2 acute pneumonitis was experienced by 3 patients (13%), grade 2 acute esophagitis was experienced by 2 patients (9%). One patient had late grade 3 esophageal toxicity. Follow-up time ranged from 6 to 99 months, median 18 months, local control rate was 100%, relapse free survival (RFS) was 96%, cancer specific survival was 96%, 2 years overall survival (OS) was 83%. Conclusion: Although our results seem to be in concordance with the literature, longer follow-up is needed to be able to make a conclusion in terms of LC, RFS and OS, since thymoma has an indolent course with low relapse rate and long RFS.

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“…Çoğunluğunu timomalar oluşturmaktadır ve timik karsinomlara nispeten daha iyi prognoza sahiptir (15) .…”

Section: Discussionunclassified

“…Zhou ve ark. 'nın (15) metaanalizinde evre II, III timomada PORT'nin genel sağkalımı arttırdığı, modern RT teknikleri ile bu artışın daha fazla olduğu belirtilmiştir. Tüm bu çalışmalar tedavi kararı vermede yalnızca evrenin yeterli olmadığını, DSÖ sınıfla-ması ve diğer PF'nin de dikkate alınarak uygun tedavi kararı verilebilmesi gerekliliğini göstermektedir.…”

Section: Discussionunclassified

Prognostic Factors and Radiotherapy in Thymic Epithelial Tumors: A single institutional experience

Temelli¹,

Ekici²,

Kekilli³

2017

Okmeydani Medical Journal

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Amaç: Timik epitelyal tümörler (TET) nadir görülür ve Material and Methods: We retrospectively analysed clinical features of TET and the correlation of World Health Organisation (WHO) histologic classification and Masaoka staging system with radiotherapy modalities in 18 patients from 2004 to 2015.Results: Our patients' male/female ratio was 10/8. Median age was 49 (range: 18-76). Fifteen patients were thymoma and 3 patients were thymic carcinoma. According to Masaoka staging; patients were distributed as Stage I 5.6% (n=1), Stage II 50% (n=9), Stage III 16.7% (n=3) and Stage IV 27,7% (n=5)

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The Effectiveness of Postoperative Radiotherapy in Patients With Completely Resected Thymoma: A Meta-Analysis

Cited by 43 publications

References 25 publications

Surgical effect and prognostic factors of myasthenia gravis with thymomas

Surgical effect and prognostic factors of myasthenia gravis with thymomas

Role of radiotherapy in Masaoka stage II and III thymomas - single center experience

Prognostic Factors and Radiotherapy in Thymic Epithelial Tumors: A single institutional experience

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