The Prognostic Value of Postoperative Radiotherapy for Thymoma and Thymic Carcinoma: A Propensity-Matched Study Based on SEER Database

Zhang, Chi; Wang, Qin; Hu, Liwen; Cong, Zhuang‐Zhuang; Yong, Qiang; Xu, Fei; Zheng, Z. P.; Luo, Cheng; Qiu, Bingmei; Li, Xiaokun; Shen, Yi

doi:10.3390/cancers14194938

Cited by 5 publications

(6 citation statements)

References 32 publications

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“…The propensity score matching analysis with data from SEER database showed that PORT improved the OS and cancer‐specific survival of patients with Masaoka‐Koga stage IIB–IV TM, but had no significant survival benefit for patients with stage I–IIA TM. This study also proved the prognostic benefit of PORT in stage IIB TC for the first time 25 …”

Section: Radiotherapysupporting

confidence: 67%

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Chinese expert consensus on the diagnosis and treatment of thymic epithelial tumors

Zhang

Wang

et al. 2023

Thoracic Cancer

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Thymic epithelial tumors (TETs) are a relatively rare type of thoracic tumor, accounting for less than 1% of all tumors. The incidence of TETs is about 3.93/10000 in China, slightly higher than that of European and American countries. For resectable TETs, complete surgical resection is recommended. Radiotherapy or chemotherapy may be used as postoperative adjuvant treatment. Treatment for advanced, unresectable TETs consist mainly of radiotherapy and chemotherapy, but there is a lack of standard first‐ and second‐line treatment regimens. Recently, targeted therapies and immune checkpoint inhibitors have shown promising outcomes in TETs. Based on the currently available clinical evidences and the opinions of the national experts, the Thymic Oncology Group of Yangtze River Delta Lung Cancer Cooperation Group (East China LUng caNcer Group, ECLUNG; Youth Committee) established this Chinese expert consensus on the clinical diagnosis and treatment of TETs, covering the epidemiology, diagnosis, treatment, prognosis and follow‐up of TETs.

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Section: Radiotherapysupporting

confidence: 67%

“…This study also proved the prognostic benefit of PORT in stage IIB TC for the first time. 25 A prospective study conducted in 22 patients with locally advanced TET (stage III/IV) evaluated the efficacy of neoadjuvant CRT. Most (77%) patients can achieve R0 resection after neoadjuvant CRT.…”

Section: Who Classification Structural Variation Gene Mutationmentioning

confidence: 99%

Chinese expert consensus on the diagnosis and treatment of thymic epithelial tumors

Zhang

Wang

et al. 2023

Thoracic Cancer

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“…Other studies have yielded different results, and the reason may be that the data processing was different— i.e. , putting stages III and IV into one group ( 29 – 31 ). The role of postoperative radiotherapy is controversial in patients with advanced thymic tumors, but some reports have recommended it ( 32 – 34 ).…”

Section: Discussionmentioning

confidence: 99%

“…In a study, postoperative radiotherapy had no significant effect on diseasespecific survival but had a positive effect on overall survival time in patients with stage IV disease (15). Other studies have yielded different results, and the reason may be that the data processing was different-i.e., putting stages III and IV into one group (29)(30)(31). The role of postoperative radiotherapy is controversial in patients with advanced thymic tumors, but some reports have recommended it (32-34).…”

Section: B Amentioning

confidence: 99%

The role of surgery in advanced thymic tumors: A retrospective cohort study

Tian

2023

Front. Oncol.

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BackgroundThere is no definitive and detailed treatment guideline for advanced thymic tumors, thus when lymph node and other organ metastasis are present, clinical guidelines recommend chemotherapy-based multidisciplinary treatment. A consensus has been reached that surgery has beneficial effects on partial patients with stage IVA whose metastatic lesions were isolated and resectable, but because of few cases of advanced thymic tumor s and the scarcity of reports, the role of surgery in stage IVB is still unknown. The current study aimed to systematically analyze the role of surgery in advanced thymic tumors based on the Surveillance, Epidemiology, and End Results (SEER) database, with a sufficient number of cases. A secondary aim was to clarify the prognostic value of surgery in advanced thymic tumors.MethodData derived from a total of 979 patients with advanced thymoma or advanced thymic carcinoma were collected from the SEER database. Propensity score matching was performed to eliminate confounding factors, and Cox regression analyses were conducted to assess prognoses.ResultsPatients were assigned to four groups based on pathology and whether surgery was performed; thymoma (surgery), thymoma (no surgery), thymic carcinom a (surgery), and thymic carcinoma (no surgery). Disease-specific survival differed significantly in the thymoma (surgery) and thymoma (no surgery) groups, both before and after propensity score matching (both p < 0.001). Similarly, disease-specific survival differed significantly in the thymic carcinoma (surgery) and the thymic carcinoma (no surgery) groups (p < 0.001 before and p = 0.003 after). No total resection, distant metastasis, and thymic carcinoma were all unfavorable prognostic factors.ConclusionsIn the present study surgery had positive effects on advanced thymoma and advanced thymic carcinoma patients who could undergo surgical resection, significantly improving survival times. Total resection of the primary site was the most advantageous form of surgery. The study provides a reference for the clinical treatment of advanced thymic tumors.

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“…In addition, some population-based studies found no significant difference in OS or freedom from recurrence in stage II patients who received adjuvant radiation after surgery [35,36]. In summary, although PORT is controversial in patients with R0 resection, it is highly recommended for patients with thymomas who underwent incomplete resection, especially for patients with advanced thymomas [37][38][39]. In our study, although there was no significant difference between elderly thymoma patients who received PORT and those who did not, the risk of OS in patients who received PORT tended to decrease (HR = 0.83, p = 0.445).…”

Section: Discussionmentioning

confidence: 99%

Clinical Features, Treatment Modalities, and Outcomes of Elderly Thymoma Patients: A Propensity-Matched Study Based on the SEER Database

Wang,

Gong,

Zhang

et al. 2023

Oncol Res Treat

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Introduction: Thymoma is a common mediastinal tumor, but few studies have been performed in thymoma patients 80 years or older. This study aimed to analyze the clinical features, treatment modalities and survival outcomes of thymoma patients at least 80 years old and compare these features to those of patients younger than 80 years old. Method: Data from thymoma patients in the Surveillance, Epidemiology and End Results database between 2000 and 2019 were selected. Clinical features, treatment modalities of the two age groups were compared. Survival rates were calculated by the Kaplan-Meier method and the log-rank test was used to compare survival rates between two groups. Propensity score matching was used based on whether surgery was performed. Univariate and multivariate Cox proportional–hazards regression analyses were performed to identify independent prognostic factors. Results: Compared with the younger patients, the patients aged 80 years or older had a similar distribution of Masaoka–Koga tumor stage, a higher proportion of type A thymoma, and a lower recurrence rate in the early stage. In elderly patients after propensity score matching, the overall survival and cancer–specific survival were better in the surgery group with complete resection and similar benefit from surgery as younger patients were observed. Conclusion: In thymoma patients aged 80 years or older, surgery still plays an important role in survival outcome. Compared with younger patients, older patients had unique clinical features.

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The Prognostic Value of Postoperative Radiotherapy for Thymoma and Thymic Carcinoma: A Propensity-Matched Study Based on SEER Database

Cited by 5 publications

References 32 publications

Chinese expert consensus on the diagnosis and treatment of thymic epithelial tumors

Chinese expert consensus on the diagnosis and treatment of thymic epithelial tumors

The role of surgery in advanced thymic tumors: A retrospective cohort study

Clinical Features, Treatment Modalities, and Outcomes of Elderly Thymoma Patients: A Propensity-Matched Study Based on the SEER Database

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