Postoperative radiation therapy is associated with longer overall survival in completely resected stage II and III thymoma - An analysis of the International Thymic Malignancies Interest Group retrospective database Journal Article
| Authors: | Rimner, A.; Yao, X.; Huang, J.; Antonicelli, A.; Ahmad, U.; Korst, R. J.; Detterbeck, F.; Gomez, D. R. |
| Article Title: | Postoperative radiation therapy is associated with longer overall survival in completely resected stage II and III thymoma - An analysis of the International Thymic Malignancies Interest Group retrospective database |
| Abstract: | Objectives: The aim of this study was to determine whether postoperative radiation therapy (PORT) is associated with an overall survival (OS) benefit in patients with completely resected Masaoka or Masaoka-Koga stage II and III thymoma. Methods: All patients with completely resected (R0) stage II or III thymoma were identified in a large database of the International Thymic Malignancy Interest Group. Clinical, pathologic, treatment, and follow-up information were extracted. OS was the primary end point. A univariate analysis using the log-rank test was performed, and a multivariate Cox model was created to identify factors associated with OS. Results: Of 1263 patients meeting the selection criteria, 870 (69%) had stage II thymoma. The WHO histologic subtype was A/AB in 360 patients (30%) and B1/B2/B3 in 827 (70%). PORT was given to 55% of patients (n = 689), 15% (n = 180) received chemotherapy, and 10% (n = 122) received both. The 5- and 10-year OS rates for patients having undergone an operation plus PORT were 95% and 86%, respectively, compared with 90% and 79% for patients receiving an operation alone (p = 0.002). This OS benefit remained significant when patients with stage II (p = 0.02) and stage III thymoma (p = 0.0005) were analyzed separately. On multivariate analysis, earlier stage, younger age, absence of paraneoplastic syndrome, and PORT were significantly associated with improved OS. Conclusions: We observed an OS benefit with the use of PORT in completely resected stage II and III thymoma. In the absence of a randomized trial, this represents the most comprehensive analysis of individual patient data and strong evidence in favor of PORT in this patient population. © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved. |
| Keywords: | thymoma; international thymic malignancy interest group; complete resection; postoperative radiation therapy; stage ii-iii |
| Journal Title: | Journal of Thoracic Oncology |
| Volume: | 11 |
| Issue: | 10 |
| ISSN: | 1556-0864 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2016-10-01 |
| Start Page: | 1785 |
| End Page: | 1792 |
| Language: | English |
| DOI: | 10.1016/j.jtho.2016.06.011 |
| PROVIDER: | scopus |
| PUBMED: | 27346413 |
| PMCID: | PMC5257334 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 November 2016 -- Source: Scopus |
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