Clinical Outcomes of Up-front Surgery Versus Surgery After Induction Chemotherapy for Thymoma and Thymic Carcinoma: A Retrospective Study.

Abstract

INTRODUCTION:

Although induction chemotherapy improves the resectability of thymic neoplasms, it is unclear whether surgery after induction chemotherapy can improve outcomes. We compared long-term outcomes of surgery with and without induction chemotherapy in patients with thymic neoplasms.

PATIENTS AND METHODS:

We retrospectively investigated the clinical information of patients with thymic neoplasms at the National Taiwan University Hospital between 2005 and 2013.

RESULTS:

Of 204 patients, 119 underwent direct surgery (group 1), 45 underwent surgery after induction chemotherapy (group 2), and 40 underwent no surgery (group 3). The 5-year overall survival rates of groups 1, 2, and 3 were as follows: for 204 patients, 96.3%, 76.4%, and 35.5% (P < .001); for 119 thymoma patients, 96.6%, 88.9%, and 100.0% (P = .835); for 85 thymic carcinoma patients, 94.7%, 69.7%, and 17.7% (P < .001); for 36 American Joint Committee on Cancer (AJCC) stage III-IVA thymoma patients, 92.9%, 83.3%, and 100% (P = .833); and for 28 stage III-IVA thymic carcinoma patients, 75.0%, 76.2%, and 62.5%, (P = .160). Univariate analysis showed that for group 2 (P = .0208) and group 3 (P < .0001), thymic carcinoma pathology type (P = .0010) and stage IVB disease (P < .0001) were poor prognostic factors. Multivariate analysis found thymic carcinoma (P = .0026) and stage IVB disease (P = .0449) to be poor prognostic factors.

CONCLUSION:

Up-front surgery leads to best overall survival, and induction chemotherapy followed by surgery may improve resectability and outcomes. Only thymic carcinoma and stage IVB disease were poor prognostic factors in multivariate analysis.

• Authors: Wei-Li Ma, Chia-Chi Lin, Feng-Ming Hsu, Jang-Ming Lee, Jin-Shing Chen, Min-Shu Hsieh, Yih-Leong Chang, Ying-Ting Chao, Chin-Hao Chang, James Chih-Hsin Yang
• Journal: Clinical lung cancer (Clin Lung Cancer) Vol. 20 Issue 6 Pg. e609-e618 (11 2019) ISSN: 1938-0690 [Electronic] United States
• PMID: 31377141 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019. Published by Elsevier Inc.

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Induction Chemotherapy (methods)
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• Retrospective Studies
• Thymectomy
• Thymoma (drug therapy, surgery)
• Thymus Neoplasms (drug therapy, surgery)
• Treatment Outcome
• Young Adult