Abstract
BackgroundThymic epithelial tumors are rare neoplasias. There are no internationally accepted standards to treat this complex oncological disease. The studies on which our knowledge is based frequently have methodological weaknesses. If the tumor is resectable, complete surgical excision is currently the first-line therapy. Thymic epithelial tumors respond to radiation. The therapeutic benefit of adjuvant radiotherapy depends on tumor stage. To validate and improve treatment, we share our current experiences with clinical management and surgical intervention.MethodsThis single-center retrospective study included 40 patients with primarily resectable thymic epithelial tumors who underwent resection with curative intent. The survival data was collected and presented according to Kaplan-Meier. Single- and multiple predictor survival analyses were carried out using the log-rank test and Cox proportional hazards model.ResultsSingle-predictor survival analysis showed survival to be dependent on the Masaoka-Koga classification, WHO histological classification, resection status, surgical technique, and Clavien-Dindo grade for postoperative complications. Multiple predictor analysis confirms that the Masaoka-Koga stage (HR = 4.876, P = 0.032) and Clavien-Dindo grade (HR = 4.904, P = 0.011) are independent prognostic factors for survival.ConclusionIn addition to the Masaoka stage, the occurrence of severe postoperative complications represents an independent prognostic factor. Given the tumor’s sensitivity to radiation, the use of neoadjuvant radiotherapy can be considered to downstage Masaoka-Koga stages III and higher, thus reducing surgical risks. Further prospective multicenter studies are urgently needed.
Highlights
IntroductionThere are no internationally accepted standards to treat this complex oncological disease
The multiple predictor analysis of our study shows that a complication corresponding to Clavien-Dindo grade IIIb or higher is an independent prognostic factor for survival (HR = 4.904 [95% Cl 1.447; 16.623], P = 0.011)
The efficacy of postoperative radiotherapy can be confirmed by these study findings
Summary
There are no internationally accepted standards to treat this complex oncological disease. If the tumor is resectable, complete surgical excision is currently the first-line therapy. To validate and improve treatment, we share our current experiences with clinical management and surgical intervention. The 5-year survival rate is 30 to 60% for patients with thymic carcinoma [3]. The included cases have heterogeneous treatment modalities, could have taken place as long as up to 50 years ago, and do not take the interim progress in surgical interventions or radiotherapy into account [7,8,9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
