Oral 2.02: The role of postoperative radiotherapy for stage I/II/III thymic tumor—results of chart database
Treatment and Novel Approaches

Oral 2.02: The role of postoperative radiotherapy for stage I/II/III thymic tumor—results of chart database

Jian-Hua Fu1, Qian-Wen Liu1, Fu Yang2, Wen-Tao Fang3, Ke-Neng Chen4, Zhen-Tao Yu5, Yong-Tao Han6, Yin Li7, Li-Jie Tan8, Lie-Wen Pang9, Yi Shen10, Gang Chen11, Jin Xiang12

1Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; 2Department of Thoracic Surgery, Shanghai First People’s Hospital, Shanghai 200080, China; 3Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai 200231, China; 4Department of Thoracic Surgery, Beijing Cancer Hospital, Beijing 100142, China; 5Department of Thoracic Surgery, Tianjin Medical University Cancer Institute, Tianjin 300060, China; 6Department of Thoracic Surgery, The Second People’s Hospital of Sichuan, Chengdu 610041, China; 7Department of Thoracic Surgery, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou 450008, China; 8Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; 9Department of Thoracic Surgery, Shanghai Huashan Hospital, Shanghai 200040, China; 10Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao 266005, China; 11Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China; 12Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China


Background: Postoperative radiotherapy for thymic tumor is still controversial. The object of the study is to evaluate the role of postoperative radiotherapy for stage I/II/III thymic tumor.

Methods: The database of Chinese Alliance of Research for Thymomas (ChART) was retrieved for patients with stage I/II/III thymic tumor who underwent surgical 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: One thousand five hundred and forty-six stage I/II/III patients were identified from ChART database. Among these patients, 649 (42.0%) underwent postoperative radiotherapy. Postoperative radiotherapy was associated with gender, histologic type [World Health Organization (WHO)], surgical extent, complete resection, Masaoka stage and adjuvant chemotherapy. The 5-year and 10-year overall survival (OS) rates and disease-free survival (DFS) rate for patients underwent surgery followed by postoperative radiotherapy 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. The 5-year and 10-year recurrence rate for patients underwent surgery followed by postoperative radiotherapy were 18% and 35%, comparing with 7% and 8% for patients underwent surgery alone (P<0.001). In univariate analysis, age, histologic type (WHO), Masaoka stage, completeness of resection, and postoperative radiotherapy 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 univariate analysis, myasthenia gravis, age, gender, histologic type (WHO), Masaoka stage, postoperative radiotherapy, surgical approach, tumor size 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 postoperative radiotherapy achieved better the 5-year and 10-year OS and DFS (P=0.010, 0.017, respectively). Postoperative radiotherapy did not affect the OS of patients with Masaoka stage I/II/III who underwent complete resection (P=0.067, 0.615 and 0.192, respectively).

Conclusions: The current retrospective study indicated that postoperative radiotherapy after incomplete resection could improve OS and DFS for patients with stage I/II/III thymic tumor.

Keywords: Thymic tumor; postoperative radiotherapy; survival


doi: 10.3978/j.issn.2072-1439.2015.AB059


Cite this abstract as: Fu JH, Liu QW, Yang F, Fang WT, Chen KN, Yu ZT, Han YT, Li Y, Tan LJ, Pang LW, Shen Y, Chen G, Xiang J. Oral 2.02: The role of postoperative radiotherapy for stage I/II/III thymic tumor—results of chart database. J Thorac Dis 2015;7(Suppl 3):AB059. doi: 10.3978/j.issn.2072-1439.2015.AB059

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