Thirty-Five–Year Follow-Up Analysis of Clinical and Pathologic Outcomes of Thymoma Surgery

Margaritora, Stefano; Cesario, Alfredo; Cusumano, Giacomo; Meacci, Elisa; D’Angelillo, Rolando Maria; Bonassi, Stefano; Carnassale, Giulia; Porziella, Venanzio; Tessitore, Adele; Vita, Maria Letizia; Lauriola, Libero; Evoli, Amelia; Granone, Pierluigi

doi:10.1016/j.athoracsur.2009.08.074

Cited by 125 publications

(113 citation statements)

References 36 publications

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“…The prognosis is associated with WHO histology, Masaoka stage, and complete surgical resection of the tumor. [4][5][6] Surgery alone is the gold standard treatment for early stage thymomas. [4][5][6] However, Masaoka stage IVa tumors are often not completely resectable, and the proper treatment for these patients remains unclear.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6] Surgery alone is the gold standard treatment for early stage thymomas. [4][5][6] However, Masaoka stage IVa tumors are often not completely resectable, and the proper treatment for these patients remains unclear. Multimodality strategies combining chemotherapy (CT), radiotherapy (RT), and surgery have been proposed; however, the type of surgery remains controversial.…”

Section: Introductionmentioning

confidence: 99%

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Role of Surgery in the Treatment of Masaoka Stage IVa Thymoma

Kaba

Özkan

Erus

et al. 2018

ATCS

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of Surgery in the Treatment of Masaoka Stage IVa Thymoma

Kaba

Özkan

Erus

et al. 2018

ATCS

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“…[2, 25,26] Bu çalışmalar ışığında birçok merkez kişiye özgü risk uyarlanmış tedavi yaklaşımını benimsemiş olup çeşitli prognostik gruplamalar oluşturul-muştur. Chen ve ark.…”

Section: Discussionunclassified

Thymic tumors and outcomes after radiotherapy

Sarıhan¹

2013

TJ Oncol

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OBJECTIVESWe evaluated the results of treatment in patients with thymic tumors treated with postoperative adjuvant radiotherapy. METHODSEighteen patients were treated median 5400 cGy radiotherapy between 1995-2010. Diagnosis of patients were thymoma (n=10), thymic carcinoma (n=7), thymic neuroendocrin carcinoma (n=1). R0 resection was made on 12 of them. According to prognostic stratification with Masaoka stage and WHO classification, there were 5 good, 7 moderate, and 6 poor risk patients. Survival was calculated from diagnosis. RESULTSA total of 33% patients were recurred median 29.5 months with 34 months follow-up. Local control, median overall and disease-free survival for all patients were 77%, 113 months, and 105 months. Local control for good, moderate, poor risk groups were found 100%, 71%, 50%. There were significant differences survival rates for Masaoka stage, R0 resection, and prognostic groups. CONCLUSIONPrognostic risk classification was found to be better predictive in terms of local control and survival.Key words: Thymic tumor; adjuvant radiotherapy; local control; prognostic group; survival. AMAÇCerrahi sonrası adjuvan radyoterapi uygulanan timik tümörlü olgularda tedavi sonuçları değerlendirildi. GEREÇ VE YÖNTEMOn sekiz olgu 1995-2010 arasında ortanca 5400 cGy radyoterapi ile tedavi edildi. Tanı; timoma (n=10), timik karsinom (n=7), timik nöroendokrin karsinom (n=1) olarak sıralanıyor-du. Olguların 12'sine R0 rezeksiyon yapılmıştı. Masaoka evre ve Dünya Sağlık Örgütü sınıflamasını içeren prognostik risk sınıflamasına göre; 5 iyi, 7 orta ve 6 kötü riskli hasta vardı. Sağkalım tanıdan itibaren hesaplandı. BULGULAROtuz dört aylık izlem süresi içinde olguların %33'ünde ortanca 29.5 ayda nüks görüldü. Lokal kontrol, ortanca genel ve hastalıksız sağkalım tüm olgular için; %77, 113 ay, 105 ay bulundu. İyi-orta-kötü prognostik gruplar için lokal kontrol %100, %71, %50 oldu. Masaoka evre, R0 rezeksiyon, prognostik risk grupları için sağkalım oranlarında anlamlı fark vardı. SONUÇPrognostik risk sınıflamasının lokal kontrol ve sağkalım açı-sından daha iyi prediktör olduğu görüldü.

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“…In addition, the complete surgical resection of thymoma has been reported as the only significant independent prognostic factor influencing thymoma recurrence in previously thymectomized MG patients 1,7 . MG in our patients with previous thymoma was well controlled, and they had undergone complete surgical resection.…”

Section: Discussionmentioning

confidence: 99%

“…Chest CT is currently considered the first choice for the screening of thymoma. It has been stated that chest CT scans should be conducted yearly for the first 2, 5 or 10 years following the initial thymectomy and every 2 years afterwards, especially in thymomatous patients 2,7,8 . However, routine screening of thymoma in well-controlled MG patients is rarely discussed in the literature 3 .…”

Section: Discussionmentioning

confidence: 99%

Myasthenia gravis and thymus: long-term follow-up screening of thymectomized and non-thymectomized patients

Lorenzoni

Augusto

Kay

et al. 2013

Arq. Neuro-Psiquiatr.

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Thymoma is strongly associated with myasthenia gravis (MG), particularly at the onset of the disease 1 . Thymus investigation in MG patients is typically recommended at the onset of MG or when patients present with clinical deterioration or a progressive increase of anti-acetylcholine receptor (AChR) antibody 2,3 . However, it is unknown if repeated screenings for thymoma at fixed intervals, even in the absence of MG deterioration, are necessary when the initial screening is negative. In addition, therapeutic guidelines do not mention the importance of thymus follow-up if the initial screening is negative 1,4 .The main objective of this study was to determine the recurrence rate and incidence of new thymoma in a series of MG patients without clinical deterioration who underwent long-term follow-up. METHODSWe included MG patients who fulfilled the following criteria: (1) diagnosis based on abnormal repetitive nerve ABSTRACTThymoma screening is recommended at the onset of myasthenia gravis (MG) or when patients with MG present with clinical deterioration or a progressive increase of anti-acetylcholine receptor antibody. However, it is unknown if it is necessary to repeat the screening of thymoma at fixed intervals, even in the absence of MG deterioration, when the initial screening is negative. We analyzed the recurrence rate and incidence of new thymoma in a series of patients with well-controlled MG. The sample consisted of 53 patients, aged 17 to 72 years, and the follow-up varied between 75 and 472 months. The chest computerized tomography detected thymus abnormalities in eight patients at the initial screening and no abnormalities in all patients at a second screening after five years. The findings of this study support the classical opinion that screening for thymoma should be recommended only if there is clinical deterioration due to the disease.Keywords: myasthenia gravis, thymus gland, thymoma, tomography. RESUMOA investigação de timoma é recomendada em pacientes com miastenia gravis (MG) no início da doença, em caso de haver piora clínica ou aumento dos níveis do anticorpo antirreceptor de acetilcolina. Contudo, não foi estabelecido se é necessário repetir a investigação de timoma em intervalos fixos, na ausência de piora clínica, quando a investigação inicial foi negativa. A taxa de recorrência e a incidência de novo timoma foram analisadas em uma série de pacientes com MG bem controlada. A amostra consiste de 53 pacientes, idade entre 17 e 72 anos, com tempo de acompanhamento variando entre 75 e 472 meses. A primeira tomografia computadorizada de tórax detectou anormalidades no timo em oito pacientes durante a investigação inicial da doença e nenhuma anormalidade no segundo exame, após cinco anos de doença, em todos os pacientes. Os achados desse estudo corroboram a clássica opinião de que a investigação de timoma deveria ser recomendada somente se houver piora clínica da doença.

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Thirty-Five–Year Follow-Up Analysis of Clinical and Pathologic Outcomes of Thymoma Surgery

Cited by 125 publications

References 36 publications

Role of Surgery in the Treatment of Masaoka Stage IVa Thymoma

Role of Surgery in the Treatment of Masaoka Stage IVa Thymoma

Thymic tumors and outcomes after radiotherapy

Myasthenia gravis and thymus: long-term follow-up screening of thymectomized and non-thymectomized patients

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