Surgery is the most important therapy for thymic malignances. The last decade has seen increasing adoption of minimally invasive surgery (MIS) for thymectomy. MIS for early stage thymoma patients has been shown to yield similar oncological results while being helpful in minimize surgical trauma, improving postoperative recovery, and reduce incisional pain. Meanwhile, With the advance in surgical techniques, the patients with locally advanced thymic tumors, preoperative induction therapies or recurrent diseases, may also benefit from MIS in selected cases.
Humans ; Minimally Invasive Surgical Procedures ; methods ; trends ; Retrospective Studies ; Thymoma ; surgery ; Thymus Neoplasms ; mortality ; pathology ; surgery

OBJECTIVE: To analyze the clinic and pathologic data of thymic epithelial tumor (TET) and to explore its prognostic factors. METHODS: From June 1997 to September 2007, 137 patients with TET were surgically treated in our hospital. The data included age, gender, symptoms, histological type, stage and grade, pathological findings, and operation reports. The patients were followed up by telephones and mails. The patients were divided into Masaoka I/II group and III/IV group, and WHO A/AB/B1 group and B2/B3/C group. Kaplan-Meier method, log-rank test, and COX regression model were used to analyze the prognostic factors for TET. RESULTS: Among the 137 patients, 124 (90.5%) received complete resection, 9 (6.6%) incomplete resection, and 4 (2.9%) surgical biopsy. The rate of complete resection was significantly higher in Masaoka stages I/II than that in stages III/IV (P<0.001). The overall 5-year and 10-year survival rate was 71.4å and 50.1å, respectively. Patients in stage I/II had better long-term survival than those in stage III/IV (P<0.001). According to WHO histological classification, the 5-year and 10-year survival rate in patients with Type A/AB/B1 TET was significantly higher than that in patients with Type B2/B3/C TET (P<0.001). The 5-year and 10-year survival rate in patients with complete resection was significantly higher than that in patients with incomplete resection and biopsy (P<0.001).Cox regression analysis showed that the prognosis of patients with TET was related to Masaoka stage, WHO histological classification, extent of resection, and age at operation. CONCLUSION Masaoka stage, WHO histological classification, extent of resection, and age at operation are important prognostic factors in patients with TET.
Adolescent ; Adult ; Aged ; China ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasms, Glandular and Epithelial ; mortality ; pathology ; surgery ; Prognosis ; Retrospective Studies ; Survival Rate ; Thymus Neoplasms ; mortality ; pathology ; surgery ; Young Adult

OBJECTIVETo investigate the clinicopathologic features of thymic carcinoma and assess its prognostic factors.

METHODSA retrospective analysis was performed in 54 patients with thymic carcinoma who underwent surgical resection. Eighteen patients were treated by total resection of the tumor, 17 partial resection and 10 exploratory thoracotomy. The clinical stage was determined according to Masaoka's classification. The survival time and prognostic factors were evaluated by the log-rank and Cox multivariate analysis model.

RESULTSThe overall 5-year survival rate was 44.4%. Being located in anterior mediastinum and noncalcification in the tumor pathognomonically played an important role in the differential diagnosis. According to the multivariate analysis, tumor maximum diameter (OR = 1.84), histological subtype (OR = 1.70), completeness of resection (OR = 1.37), tumor invasion of peritumoral organs (OR = 1.32) and postoperative recurrence (OR = 1.26) were significant prognostic factors. Compared with other subtypes, carcinoid tumor had the characteristics of earlier lesion, better resection rate and better prognosis.

CONCLUSIONThe most important prognostic variables for thymic carcinoma are tumor maximum diameter, histological subtype, completeness of resection, tumoral invasion and postoperative recurrence. Complete resection followed by chemoradiotherapy should be considered as favorable on the basis of a definitive pathologic diagnosis.

Adult ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Thymus Neoplasms ; mortality ; pathology ; surgery

PURPOSE: Recurrence rate is considered a better measure of clinical outcomes after thymoma resection than overall survival due to the indolent behavior of thymomas. This study was designed to determine predictors of recurrence after thymoma resection. MATERIALS AND METHODS: A single-institution, retrospective study was performed, including 305 patients who had undergone thymoma resection between 1986 and 2009. RESULTS: Among 305 patients, recurrence was observed in 41 patients (13.4%). The recurrence rates were 0% (0/19), 6.3% (4/63), 4.2% (2/48), 18.6% (11/59) and 20.7% (24/116) for type A, AB, B1, B2 and B3 tumors, respectively. The recurrence rate according to Masaoka stage was 6.1% (8/132), 11.4% (13/114), 26.8% (11/41) and 50.0% (9/18) for stages I, II, III and IV, respectively. After univariate analysis, completeness of resection (R0 versus R1), World Health Organization (WHO) histologic type (A, AB, B1 versus B2, B3), Masaoka stage, and size of tumor (<8 cm versus > or =8 cm) demonstrated significant differences with freedom from recurrence. Upon multivariate analysis, Masaoka stage was the only independent predictor of recurrence. CONCLUSION: WHO histologic type, Masaoka stage, and size of tumor were associated with recurrence. Particularly, Masaoka stage was the only independent predictor of recurrence after thymoma resection.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local/epidemiology/*etiology ; Retrospective Studies ; Thymoma/mortality/*pathology/*surgery ; Thymus Neoplasms/mortality/*pathology/*surgery ; Young Adult