Long term oncological outcome of thymoma and thymic carcinoma – an analysis of 235 cases from a single institution

Abstract

Background and objectivesThymoma has a variable long-term oncological outcome after surgical resection. Survival and tumor recurrence were analyzed to determine the predisposing factors for tumor recurrence.MethodsA total of 235 patients who underwent surgery for thymoma or thymic carcinoma from December 1997 to March 2013 were analyzed using Masaoka staging system and World Health Organization (WHO) histological classification. Surgical intervention included extended thymothymectomy via median sternotomy and thymomectomy via thoracotomy/ video-assisted thoracoscopic surgery (VATS).ResultsThe median duration of follow-up was 105 months (12–198 months). Among these 235 patients, recurrence was observed in 25 patients (10.7%). according to Masaoka stage I, IIA, IIB, III, IVA, IVB, recurrence rates were 1/65(1.5%), 8/106(7.5%), 1/32(3.1%), 6/20(30.0%), 8/10(80.0%), 1/1(100.0%), respectively. Disease or treatment-related mortality was observed in 13 patients. Overall survival rate was 94.4%. After univariate analysis, predisposing factors for tumor recurrence included Masaoka stage, WHO histologic type, tumor size, adjuvant therapy and margin status.ConclusionsDue to the indolent behavior of thymoma, tumor recurrence appears to be a better assessment of oncological outcome rather than survival. Factors associated with tumor recurrence include Masaoka stage, WHO histologic type, tumor size, adjuvant therapy and margin status.

Prognostic and diagnostic impact of fibrinogen, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio on thymic epithelial tumors outcome

“…The clinical and demographic characteristics of our study population, including female-to-male ratio, age, and percentages of TCs and MG, were comparable to those in previous publications [ 9 , 11 , 27 – 29 ]. Within our cohort, high pretreatment Fibrinogen serum concentrations were associated with advanced tumor stage, and worse FFR and CSS.…”

A case of thymoma in myasthenia gravis: Successful outcome after thymectomy

“…The management of myasthenia crisis involves securing the airway and maintaining of respiratory function [13]. Since the tumor is rare, proper staging system was not used regularly before 1981 [15,16]. Commonly used staging system for this condition is WHO staging according to which Stage B2 includes tumor in which there is Increased density of dispersed or clustered epithelial cells (≥3 adjacent cells) with moderately dense immature lymphocyte population [17].…”

Thymoma-associated Myasthenia Gravis in a Young Adult with Development of Paraneoplastic Limbic Encephalitis and Systemic Lupus Erythematosus Post-thymectomy: A Case Report

“…Oncologically, the treatment of thymomas generally involves surgical resection accompanied by adjuvant or neoadjuvant chemoradiation when there is evidence for microscopic or gross invasion [3-4]. Complete resection of the mass by thymectomy is the gold standard in the treatment of an early-stage thymoma and offers patients the best prognosis [5-7]. The National Comprehensive Cancer Network provides guidelines for management based on the tumour stage [5,8].…”

“…Radiation therapy can be used alone in an R1 resection, where there is only evidence of a microscopic tumour residue, but additional chemotherapy is recommended after an R2 resection, where there is a macroscopic residual tumour [9]. Despite aggressive therapy, advanced stage disease usually results in very poor prognoses [6-7].…”