Management and outcomes of relapse after treatment for thymoma and thymic carcinoma Journal Article
| Authors: | Bott, M. J.; Wang, H.; Travis, W.; Riely, G. J.; Bains, M.; Downey, R.; Rusch, V.; Huang, J. |
| Article Title: | Management and outcomes of relapse after treatment for thymoma and thymic carcinoma |
| Abstract: | Background: Although surgery is the mainstay of treatment for thymic tumors, recurrence is common despite resection. The optimal approach to the management of disease relapse after treatment for thymic tumors remains unclear. Methods: This study is a retrospective analysis of a single-institution experience assessing treatment patterns and outcomes in patients with recurrence or disease progression after surgical treatment for thymic tumors. Data included demographics, stage, treatment, pathologic findings, and postoperative outcomes. Results: From 1995 to 2006, 120 patients had initial resection of a thymic tumor at our institution, of which 112 had recurrence data available. Twenty-five patients developed recurrence or progression of disease after their initial resection (10 thymic carcinoma, 15 thymoma). Median follow-up was 51.4 months. Higher Masaoka stages predominated (I: 0; II: 4; III: 8; IV: 13). Eleven patients (44%) underwent surgery for their relapse with curative intent, while 14 (56%) were managed nonsurgically. Surgery was considered when disease was intrathoracic, unilateral, and technically resectable. The 11 patients receiving surgery had a total of 16 reoperations (range 1 to 4). An R0 re-resection was obtained in half of cases (8 of 16, 50%) but the majority of operative patients (9 of 11, 82%) recurred again. The 5-year overall survival of the 25 patients with recurrent or persistent disease was 58% (median survival = 82 months). Kaplan-Meier curves demonstrate a trend (p = 0.08) toward improved overall survival in patients treated with surgery versus those treated nonoperatively (median survival = 156 months versus 50 months). Patients with thymoma demonstrated a trend (p = 0.12) toward improved survival for over thymic carcinoma (median survival = 90 months versus 35 months). Conclusions: Treatment of patients with recurrent or progressive thymic tumors is associated with long-term survival. Despite the historical enthusiasm for re-resection, the majority of patients will recur again, therefore reoperation should be considered only in selected patients. © 2011 The Society of Thoracic Surgeons. |
| Keywords: | adult; cancer survival; treatment outcome; aged; aged, 80 and over; middle aged; cancer surgery; retrospective studies; major clinical study; overall survival; cancer growth; cancer adjuvant therapy; postoperative care; cancer staging; follow up; demography; neoplasm recurrence, local; thoracotomy; cohort analysis; medical record review; disease progression; reoperation; carcinoma; brachytherapy; cancer relapse; thymoma; sternotomy; pleurectomy; thymic carcinoma; thymus neoplasms; thymus cancer; chemoradiotherapy; surgical patient |
| Journal Title: | Annals of Thoracic Surgery |
| Volume: | 92 |
| Issue: | 6 |
| ISSN: | 0003-4975 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2011-12-01 |
| Start Page: | 1984 |
| End Page: | 1992 |
| Language: | English |
| DOI: | 10.1016/j.athoracsur.2011.07.078 |
| PROVIDER: | scopus |
| PUBMED: | 22115206 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 3 January 2012" - "CODEN: ATHSA" - "Source: Scopus" |
Altmetric
Citation Impact
Related MSK Work