Invasive thymoma - Which patients benefit from post-operative radiotherapy?

Autor:	Muslim Z; Department of Thoracic Surgery, Nuvance Health System, Connecticut & New York, USA.; Rudy L. Ruggles Biomedical Research Institute, Connecticut, USA., Baig MZ; Department of Thoracic Surgery, Nuvance Health System, Connecticut & New York, USA.; Rudy L. Ruggles Biomedical Research Institute, Connecticut, USA., Weber JF; Department of Thoracic Surgery, Nuvance Health System, Connecticut & New York, USA.; Rudy L. Ruggles Biomedical Research Institute, Connecticut, USA., Detterbeck FC; Department of Thoracic Surgery, Yale University School of Medicine, New Haven, USA., Connery CP; Department of Thoracic Surgery, Nuvance Health System, Connecticut & New York, USA., Spera JA; Division of Radiation Oncology, Danbury Hospital, Nuvance Health System, Connecticut, USA., Bhora FY; Department of Thoracic Surgery, Nuvance Health System, Connecticut & New York, USA.; Rudy L. Ruggles Biomedical Research Institute, Connecticut, USA.
Jazyk:	angličtina
Zdroj:	Asian cardiovascular & thoracic annals [Asian Cardiovasc Thorac Ann] 2021 Nov; Vol. 29 (9), pp. 935-942. Date of Electronic Publication: 2021 May 11.
DOI:	10.1177/02184923211017094
Abstrakt:	Background: The aim of this study is to identify patients with thymoma who should receive post-operative radiotherapy. Methods: The Surveillance, Epidemiology, and End Results database was queried for stage IIB-IV thymoma patients diagnosed during 1988-2015. We analyzed the prognostic implications of various clinical-pathological factors by comparing the outcomes of those who received surgery with and without post-operative radiotherapy. Results: A total of 1120 patients were identified; 62% received post-operative radiotherapy and 38% underwent surgery alone. In a propensity-matched cohort of 812 patients, no survival difference was seen in World Health Organization A, AB, B1, B2, or B3 tumors with the addition of post-operative radiotherapy to surgery (p>0.05). Post-operative radiotherapy also did not improve survival over surgery alone for tumors ≥ or < less than the 4 cm, 7 cm, 10 cm, and 13 cm cutoffs, all p>0.05. Post-operative radiotherapy was an independent, positive prognostic indicator only in the subgroup with stage III disease and in those receiving chemotherapy in addition to post-operative radiotherapy, both p<0.05. Conclusions: Patients with stage III thymoma are most likely to benefit from the addition of post-operative radiotherapy to surgical treatments. Tumor size or World Health Organization histology alone should not be criteria for determining the need for post-operative radiotherapy in locally advanced thymoma. Masaoka-Koga stage, which has traditionally been used to help make such decisions, appears to be the most reliable determinant of the use of post-operative radiotherapy.
Databáze:	MEDLINE
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