Role of Postoperative Radiotherapy for Stage I/II/III Thymic Tumor - Results of the ChART Retrospective Database
10.3779/j.issn.1009-3419.2016.07.09
- VernacularTitle:术后放疗在I期/II期/III期胸腺肿瘤中的作用--ChART回顾性数据库研究结果
- Author:
LIU QIANWEN
1
;
GU ZHITAO
;
YANG FU
;
FU JIANHUA
;
SHEN YI
;
WEI YUCHENG
;
TAN LIJIE
;
ZHANG PENG
;
HAN YONGTAO
;
CHEN CHUN
;
ZHANG RENQUAN
;
LI YIN
;
CHEN KE-NENG
;
CHEN HEZHONG
;
LIU YONGYU
;
CUI YOUBING
;
WANG YUN
;
PANG LIEWEN
;
YU ZHENTAO
;
ZHOU XINMING
;
LIU YANGCHUN
;
XIANG JIN
;
LIU YUAN
;
FANG WENTAO
Author Information
1. 中山大学附属肿瘤医院胸外科
- Keywords:
Thymic tumor;
Postoperative radiotherapy;
Overall survival
- From:
Chinese Journal of Lung Cancer
2016;19(7):465-472
- CountryChina
- Language:Chinese
-
Abstract:
Background and objectivePostoperative radiotherapy (PORT) for thymic tumor is still controversial. The object of the study is to evaluate the role of PORT for stage I/II/III thymic tumor.MethodsThe database of Chinese Al-liance of Research for Thymomas (ChART) was retrieved for patients with stage I/II/III thymic tumor who underwent surgi-cal therapy without neoajuvant therapy between 1994 and 2012. Univariate and multivariate survival analyses were performed. Cox proportional hazard model was used to determine the hazard ratio for death.Results 1,546 stage I/II/III patients were identiifed from ChART database. Among these patients, 649 (41.98%) underwent PORT. PORT was associated with gender, histologic type (World Health Organization, WHO), surgical extent, complete resection, Masaoka stage and adjuvant che-motherapy. The 5-yr and 10-yr overall survival (OS) rates and disease-free survival (DFS) rate for patients underwent surgery followed by PORT were 90% and 80%, 81% and 63%, comparing with 96% and 95%, 92% and 90% for patients underwent surgery alone (P=0.001,P<0.001) respectively. In univariate analysis, age, histologic type (WHO), Masaoka stage, complete-ness of resection, and PORT were associated with OS. Multivariable analysis showed that histologic type (WHO)(P=0.001), Masaoka stage (P=0.029) and completeness of resection (P=0.003) were independently prognostic factors of OS. In univari-ate analysis, gender, myasthenia gravis, histologic type (WHO), Masaoka stage, surgical approach, PORT and completeness of resection were associated with DFS. Multivariable analysis showed that histologic type (WHO) (P<0.001), Masaoka stage (P=0.005) and completeness of resection (P=0.006) were independently prognostic factors of DFS. Subgroup analysis showed that patients with incomplete resection underwent PORT achieved the better OS and DFS (P=0.010, 0.017, respectively). However, patients with complete resection underwent PORT had the worse OS and DFS (P<0.001,P<0.001, respectively). ConclusionThe current retrospective study indicated that PORT atfer incomplete resection could improve OS and DFS for patients with stage I/II/III thymic tumor. But for those atfer complete resection, PORT may not help improve prognosis on the whole.
