Role of Surgery in the Treatment of Masaoka Stage IVa Thymoma

Kaba, Erkan; Özkan, Berker; Erus, Suat; Duman, Salih; Çimenoğlu, Berk; Toker, Alper

doi:10.5761/atcs.oa.17-00108

Cited by 14 publications

(15 citation statements)

References 18 publications

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“…Interestingly, when the extent of resection was evaluated as a potential independent variable associated with either PFS or OS, it was not shown to be related to either outcome in our investigation. This finding is similar to another single center evaluation 15 . However, it should be noted that our sample size is limited and these results should serve as hypothesis‐generating findings, rather than definitive conclusions as to the optimal management strategy.…”

Section: Discussionsupporting

confidence: 87%

“…Our outcomes following surgical resection for stage IVA disease, however, are consistent with prior reports. In similar single center evaluations, 5‐year survival rates of 93% and 78% are consistent with data reported herein 15,16 . Of note, while an imperfect endpoint, PFS, and more specifically freedom from locoregional progression, serve as the most rigorous assessments of disease control, as patients managed both operatively and nonoperatively were treated with definitive, curative intent.…”

Section: Discussionsupporting

confidence: 80%

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Importance of resection for locoregional disease control in Masaoka stage IVA thymic neoplasms

Corsini

Mitchell

Hofstetter

et al. 2020

Journal of Surgical Oncology

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Background and Objectives It is unclear if a specific strategy for simultaneous treatment of primary thymic neoplasms and pleural metastases confers benefit for Masaoka stage IVA disease. We reviewed our experience with thymic neoplasms with concurrent pleural metastases to identify factors influencing outcomes. Methods Records of patients who presented with stage IVA thymic neoplasms from 2000 to 2018 were assessed. Multivariate Cox proportional hazards analyses were completed to determine predictors of progression‐free and overall survival. Results Forty‐eight patients were identified, including 34 (71%) who underwent surgery. Median overall and progression‐free survival were 123 and 21 months, respectively. The extent of resection varied, and was most commonly thymectomy plus partial pleurectomy (22, 65%). Median progression‐free survival for patients who underwent surgical resection versus those who had not was 24 versus 12 months (P = .018). Following surgical resection, mediastinal recurrence was uncommon (2, 6%, vs 7, 50% nonoperatively). Five‐year survival rates in these groups were suggestive of possible benefit to surgery (87% vs 68%). Conclusions Thymic neoplasms with pleural dissemination represents a treatment challenge. As part of a multidisciplinary approach, surgery appears to be associated with more favorable long‐term results, although selection bias may account for some of the survival differences observed.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 80%

Importance of resection for locoregional disease control in Masaoka stage IVA thymic neoplasms

Corsini

Mitchell

Hofstetter

et al. 2020

Journal of Surgical Oncology

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“…It is well established that surgical resection is the mainstay of thymoma treatment, and can improve survival even in patients with stage IV disease. 15,16 We found that this was reflected in real-world practice, with treatment approaches including surgical resection being the most common for both stage III and IV thymoma in the United States. Surgical resection was often one component of multimodality therapy.…”

Section: Commentmentioning

confidence: 94%

Management and Long-Term Outcomes of Advanced Stage Thymoma in the United States

Khorfan

Bharat

Odell

2021

The Annals of Thoracic Surgery

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“…Furthermore, both the histotype and stage correlated with disease-free survival. Therefore, accurate preoperative classification can help develop individualized treatment methods for TET patients and improve prognosis (8,9).…”

Section: Introductionmentioning

confidence: 99%

CT-Based Radiomics Signatures for Predicting the Risk Categorization of Thymic Epithelial Tumors

et al. 2021

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ObjectivesThis study aims to assess the performance of radiomics approaches based on 3D computed tomography (CT), clinical and semantic features in predicting the pathological classification of thymic epithelial tumors (TETs).MethodsA total of 190 patients who underwent surgical resection and had pathologically confirmed TETs were enrolled in this retrospective study. All patients underwent non-contrast-enhanced CT (NECT) scans and contrast-enhanced CT (CECT) scans before treatment. A total of 396 hand-crafted radiomics features of each patient were extracted from the volume of interest in NECT and CECT images. We compared three clinical features and six semantic features (observed radiological traits) between patients with TETs. Two triple-classification radiomics models (RMs), two corresponding clinical RMs, and two corresponding clinical-semantic RMs were built to identify the types of the TETs. The area under the receiver operating characteristic curve (AUC) and accuracy (ACC) were useful to evaluate the different models.ResultsOf the 190 patients, 83 had low-risk thymoma, 58 had high-risk thymoma, and 49 had thymic carcinoma. Clinical features (Age) and semantic features (mediastinal fat infiltration, mediastinal lymph node enlargement, and pleural effusion) were significantly different among the groups(P < 0.001). In the validation set, the NECT-based clinical RM (AUC = 0.770 for low-risk thymoma, 0.689 for high-risk thymoma, and 0.783 for thymic carcinoma; ACC = 0.569) performed better than the CECT-based clinical-semantic RM (AUC = 0.785 for low-risk thymoma, 0.576 for high-risk thymoma, and 0.774 for thymic carcinoma; ACC = 0.483).ConclusionsNECT-based and CECT-based RMs may provide a non-invasive method to distinguish low-risk thymoma, high-risk thymoma, and thymic carcinoma, and NECT-based RMs performed better.Advances in KnowledgeRadiomics models may be used for the preoperative prediction of the pathological classification of TETs.

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Role of Surgery in the Treatment of Masaoka Stage IVa Thymoma

Cited by 14 publications

References 18 publications

Importance of resection for locoregional disease control in Masaoka stage IVA thymic neoplasms

Importance of resection for locoregional disease control in Masaoka stage IVA thymic neoplasms

Management and Long-Term Outcomes of Advanced Stage Thymoma in the United States

CT-Based Radiomics Signatures for Predicting the Risk Categorization of Thymic Epithelial Tumors

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