Surgical outcomes and reevaluation of treatment strategies for thymomas

Ito,Hiroyuki; Nakayama,Haruhiko; Tsuboi,Masahiro; Suga,Yasuhiro; Ishikawa,Yoshihiro; Watanabe,Hajime; Kameda,Yoichi; Yokose,Tomoyuki; Hasegawa,Chikako

doi:10.3892/ol_00000133

July-August 2010 Volume 1 Issue 4

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

July-August 2010 Volume 1 Issue 4

Full Size Image

Article

Surgical outcomes and reevaluation of treatment strategies for thymomas

Authors:
- Hiroyuki Ito
- Haruhiko Nakayama
- Masahiro Tsuboi
- Yasuhiro Suga
- Yoshihiro Ishikawa
- Hajime Watanabe
- Yoichi Kameda
- Tomoyuki Yokose
- Chikako Hasegawa
View Affiliations / Copyright

Affiliations: Division of Thoracic Surgery, Kanagawa Cancer Center, Kanagawa 241-0815, Japan. jza01742@nifty.com
Pages: 761-764
|
Published online on: July 1, 2010

https://doi.org/10.3892/ol_00000133
Expand metrics +

Abstract

Improved histological typing systems for thymic tumors and advances in induction and adjuvant therapy have created the need to reevaluate strategies for the management of thymoma. We retrospectively studied 73 patients with completely resected thymomas unassociated with myasthenia gravis. The World Health Organization (WHO) histologic classification, clinicopathological features and surgical outcomes were analyzed. Overall survival was 66.2% at 10 years, and the median survival time was 169 months. According to the Masaoka staging system, overall survival rates at 10 years were 94.7% in stage I, 76.1% in stage II, 30% in stage III and 0% in stage IV. In the WHO classification, overall survival rates at 10 years were 91.9% in types A and AB, 50.9% in type B2 and not achieved in type B3. The disease-free interval was slightly shorter in patients with B2 and B3 disease than in those with type A, AB and B1 disease. Advanced thymomas were significantly associated with type B2 and B3 (p<0.01). In stage III and IV disease, adjuvant or neoadjuvant therapy was associated with better survival as compared to no adjuvant therapy (p=0.07). On multivariate analysis, Masaoka stage III and IV disease and extended thymectomy indicated significant, negative and independent risk factors for survival (p<0.01). Masaoka stage I and II thymomas or WHO type A and AB thymomas have favorable prognoses and do not require postoperative adjuvant therapy. Patients with stage III and IV thymomas require additional therapy after surgery.

View Figures

View References

1	Shields TW: Thymic tumors. Tymic Tumors. Shields TW, Locicero J III and Ponn RB: General thoracic surgery. fifth edition. Lippincott Williams and Wilkins; Philadelphia: pp. 2181–2205. 2000
2	Cowen D, Richaud P, Mornex F, et al: Thymoma. Results of a multicentric retrospective series of 149 non-metastatic irradiated patients and review of the literature FNCLCC trialists Federation Nationale des Centres de Lutte Contre le Cancer. Radiother Oncol. 34:9–16. 1995. View Article : Google Scholar
3	Hejna M, Haberl I and Raderer M: Nonsurgical management of malignant thymoma. Cancer. 85:1871–1884. 1999. View Article : Google Scholar : PubMed/NCBI
4	Igawa S, Murakami H, Takahashi T, et al: Efficacy of chemotherapy with carboplatin and paclitaxel for unresectable thymic carcinoma. Lung Cancer. 67:194–197. 2010. View Article : Google Scholar : PubMed/NCBI
5	Kim ES, Putnam JB, Komaki R, et al: Phase II study of a multidisciplinary approach with induction chemotherapy, followed by surgical resection, radiation therapy, and consolidation chemotherapy for unresectable malignant thymomas: final report. Lung Cancer. 44:369–379. 2005. View Article : Google Scholar
6	Rea F, Sartori F, Loy M, Calabrò F, Fornasiero A, Daniele O and Altavilla G: Chemotherapy and operation for invasive thymoma. J Thorac Cardiovasc Surg. 106:543–549. 1993.PubMed/NCBI
7	Berruti A, Borasio P, Gerbino A, et al: Primary chemotherapy with adriamycin, cisplatin, vincristine and cyclophosphamide in locally advanced thymomas: a single institution experience. Br J Cancer. 81:841–845. 1999. View Article : Google Scholar : PubMed/NCBI
8	Masaoka A, Monden Y, Nakahara K and Tanioka T: Follow-up study of thymomas with special reference to their clinical stages. Cancer. 48:2485–2492. 1981. View Article : Google Scholar : PubMed/NCBI
9	Shimosato Y: Controversies surrounding the subclassification of thymoma. Cancer. 74:542–544. 1994. View Article : Google Scholar : PubMed/NCBI
10	Rosai J: World Health Organization International Histological Classification of Tumours. Histological Typing of Tumours of the Thymus. 2nd edition. Springer-Verlag; New York: 1999, View Article : Google Scholar
11	Rena O, Papalia E, Maggi G, et al: World Health Organization histologic classification: an independent prognostic factor in resected thymomas. Lung Cancer. 50:59–66. 2005. View Article : Google Scholar : PubMed/NCBI
12	Kondo K, Yoshizawa K, Tsuyuguchi M, et al: WHO histologic classification is a prognostic indicator in thymoma. Ann Thorac Surg. 77:1183–1188. 2004. View Article : Google Scholar : PubMed/NCBI
13	Okumura M, Ohta M, Tateyama H, et al: The World Health Organization histologic classification system reflects the oncologic behavior of thymoma: a clinical study of 273 patients. Cancer. 94:624–632. 2002. View Article : Google Scholar
14	Pollock RE, Doroshow JH, Khayat D, et al: UICC Manual of Clinical Oncology. 8th edition. Wiley-Liss; NY: 2004
15	Zisis C, Rontogianni D, Tzavara C, et al: Prognostic factors in thymic epithelial tumors undergoing complete resection. Ann Thorac Surg. 80:1056–1062. 2005. View Article : Google Scholar : PubMed/NCBI
16	Detterbeck FC: Clinical value of the WHO classification system of thymoma. Ann Thorac Surg. 81:2328–2334. 2006. View Article : Google Scholar : PubMed/NCBI
17	Masaoka A, Yamakawa Y, Niwa H, et al: Extended thymectomy for myasthenia gravis patients: a 20-year review. Ann Thorac Surg. 62:853–859. 1996.PubMed/NCBI
18	Namba T, Brunner NG and Grob D: Myasthenia gravis in patients with thymoma, with particular reference to onset after thymectomy. Medicine. 57:411–433. 1978. View Article : Google Scholar : PubMed/NCBI
19	Rosenow EC III and Hurley BT: Disorders of the thymus. A review. Arch Intern Med. 144:763–770. 1984. View Article : Google Scholar : PubMed/NCBI
20	Kondo K and Monden Y: Myasthenia gravis appearing after thymectomy for thymoma. Eur J Cardiothorac Surg. 28:22–25. 2005. View Article : Google Scholar : PubMed/NCBI
21	Nakahara K, Ohno K, Hashimoto J, et al: Thymoma: results with complete resection and adjuvant postoperative irradiation in 141 consecutive patients. J Thorac Cardiovasc Surg. 95:1041–1047. 1988.PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Surgical outcomes and reevaluation of treatment strategies for thymomas

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Related Articles