Skip Navigation LinksHome > July 2014 - Volume 9 - Issue 7 > Prognostic Factors for Cure, Recurrence and Long-Term Surviv...
Journal of Thoracic Oncology:
doi: 10.1097/JTO.0000000000000215
Original Articles

Prognostic Factors for Cure, Recurrence and Long-Term Survival After Surgical Resection of Thymoma

Safieddine, Najib MD*; Liu, Geoffrey MD; Cuningham, Kris MD; Ming, Tsao MD; Hwang, David MD; Brade, Anthony MD§; Bezjak, Andrea MD§; Fischer, Stefan MD*; Xu, Wei PhD; Azad, Sassan BSc*; Cypel, Marcelo MD*; Darling, Gail MD*; Yasufuku, Kazu MD*; Pierre, Andrew MD*; de Perrot, Marc MD*; Waddell, Tom MD*; Keshavjee, Shaf MD*

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Abstract

Introduction:

To determine long-term outcome and risk factors for recurrence after thymectomy.

Methods:

Patients who underwent thymectomy (n = 262) for a thymic tumor (1986–2010) were identified from a prospective database. Patients were classified according to World Helath Organization (WHO) histologic classification, Masaoka staging system, and completeness of resection. Risk factors for recurrence: WHO histology, tumor size, Masaoka stage and completeness of resection were analyzed.

Results:

Of 262 patients, 51% were female, median age was 55 years, and 39% had myasthenia gravis. Median follow-up was 7.5 years, median tumor size was 5.4 cm, and Masaoka stage distribution was: I (25%), II (47%), III (17%), IV (4%), and (7%) not classified. Of 200 patients classified under the WHO system, there were (7%) type A, (22%) type AB, and (71%) type B; 83% had complete resection. One-hundred and sixty-nine patients received adjuvant radiotherapy, eight adjuvant chemoradiotherapy and 14 neoadjuvant chemoradiotherapy. Overall survival was 95% at 5 years, 91% at 10 years and 91% at 15 years. Recurrence occurred in 12 patients and disease-related death in four patients. Five patients underwent re-resection for recurrence with survival of 2–15 years. Only Masaoka stage and tumor size were associated with statistically significant risk of recurrence on multivariate analysis.

Conclusion:

Resectable thymoma is associated with excellent prognosis. Aggressive resection of recurrent disease yielded excellent long-term results. Higher Masaoka stage is associated with a greater chance of incomplete resection. Higher Masaoka stage and increasing tumor size are independent factors associated with recurrence.

Copyright © 2014 by the International Association for the Study of Lung Cancer

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