| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2005;130:1413-1421
© 2005 The American Association for Thoracic Surgery
General Thoracic Surgery |
Division of General Thoracic Surgery, Massachusetts General Hospital, Department of Surgery, Harvard Medical School, Boston, Mass
Read at the Eighty-fifth Annual Meeting of The American Association for Thoracic Surgery, San Francisco, Calif, April 10-13, 2005.
Received for publication April 4, 2005; revisions received June 27, 2005; accepted for publication July 11, 2005. * Address for reprints: Cameron D. Wright, MD, Blake 1570, Massachusetts General Hospital, Boston, MA 02114 (Email: wright.Cameron{at}mgh.harvard.edu).
OBJECTIVE: This study sought to define predictors of recurrence after resection of thymic tumors.
METHODS: A single-institution retrospective study was performed of 179 patients who underwent resection of a thymic tumor from 1972 through 2003.
RESULTS: Resection was complete in 90% (161/179) of patients. After a median follow-up of 115 months, the recurrence rate was 11% (20/179), the tumor-related death rate was 7.8% (14/179), and the overall death rate was 36.3% (65/179). Tumor recurrence correlated with advanced stage and histology (P < .0001). The difference in recurrence between Masaoka stage I (0) and II (1.7% [1/59]) was insignificant. Recurrence rates correlated with World Health Organization tumor type: A and AB, 0%; B1 and B2, 8% (4/51); B3, 27% (14/51); and C, 50% (2/4; P < .0001). Tumor size separation into quintiles demonstrated a step-up of recurrence at 8 cm (<8 cm, 1.8% [2/113]; 
8 cm, 28% [18/64]; P < .003). Multivariate Cox modeling demonstrated that Masaoka stage (odds ratio, 5.70; P < .001), World Health Organization histology (odds ratio, 5.77; P = .003), and size (odds ratio, 1.16; P = .001) were independent predictors of recurrence.
CONCLUSION: The Masaoka staging system could be collapsed to 3 degrees of invasion by combining stages I and II. The World Health Organization histologic type can be simplified for clinical use into A (A, AB), early B (B1, B2), advanced B (B3), and C tumors. Size of 8 cm or larger is an independent risk factor, even when patients with Masaoka stage III tumors are considered alone, and might identify candidates for preoperative therapy.
This article has been cited by other articles:
|
|
 |
|
  E. O. Gamboa, V. Sawhney, R. S. Lanoy, N. A. Haller, A. T. Powell, and S. V. Hazra Widespread Metastases After Resection of Noninvasive Thymoma J. Clin. Oncol., April 1, 2008; 26(10): 1752 - 1755. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Huang, G. J. Riely, K. E. Rosenzweig, and V. W. Rusch Multimodality Therapy for Locally Advanced Thymomas: State of the Art or Investigational Therapy? Ann. Thorac. Surg., February 1, 2008; 85(2): 365 - 367. [Full Text] [PDF]
|
|
|
|
|
|
C. D. Wright, N. C. Choi, J. C. Wain, D. J. Mathisen, T. J. Lynch, and P. Fidias Induction Chemoradiotherapy Followed by Resection for Locally Advanced Masaoka Stage III and IVA Thymic Tumors Ann. Thorac. Surg., February 1, 2008; 85(2): 385 - 389. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. D. Wright, P. Fidias, N. C.H. Choi, J.-A. O. Shepard, and R. P. Hasserjian Case 16-2007 -- A 61-Year-Old Man with a Mediastinal Mass N. Engl. J. Med., May 24, 2007; 356(21): 2185 - 2193. [Full Text] [PDF]
|
|
|
|
|
|
C. D. Wright Pleuropneumonectomy for the Treatment of Masaoka Stage IVA Thymoma. Ann. Thorac. Surg., October 1, 2006; 82(4): 1234 - 1239. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
