Thymic malignancies: Prognostic factors, multimodal management and the role of postoperative radiotherapy

Zhou Sha; Ling Ye; Hongying Liu; LiRu He; WeiJun Ye; XinPing Cao; YuJing Zhang; Kai Chen

Volume : VII, Issue : X, October - 2017

Thymic malignancies: Prognostic factors, multimodal management and the role of postoperative radiotherapy

Zhou Sha, Ling Ye, Hongying Liu, Liru He, Weijun Ye, Xinping Cao, Yujing Zhang, Kai Chen

Abstract :

Purpose

Thymomas and thymic carcinomas are rare malignant neoplasms and behave variably in clinics. In this retrospective observational study, our primary study aim was to determine prognostic factors in thymomas and thymic carcinoma patients and the impact of postoperative radiotherapy (PORT).

Methods

All 121 patients with thymoma or thymic carcinoma in Sun Yat–sen University Cancer Center between 2001 and 2014 were performed a retrospective analysis.

Results

Five–year os for stages I, II, III, and IV was 94.4%, 90.0%, 60.0%, 43.5% and ten–year os was 83.3%, 81.8%, 41.6%, and 11.2%, respectively. Patients with thymoma had a better survival compared with thymic carcinoma (5–year os: 76.0% vs 42.3%). For patients with locally advanced disease (stages III and IVA), the 5–year os (77.1% vs. 60.0%) and 10–year os (56.9% vs 0%) were both significantly improved by adding PORT. While in Masaoka Stage II, no benefit was noted for PORT.

Conclusions

Masaoka–Koga stage and WHO type were both important prognostic factors. The ideal management for thymomas and thymic carcinomas requires a multidisciplinary regimen with postoperative radiotherapy in locally advanced disease. Radiation toxicity was mild in most patients and no severe toxicity was registered.