Abstract
Currently, surgery remains the main therapeutic modality of thymoma, but the management of unresectable thymoma is still unclear. This study aims to identify the impact of different therapeutic model on outcomes in unresectable Masaoka-Koga stage III-IV thymoma. We retrospectively analyzed the database of the patients diagnosed with Masaoka-Koga stage III-IV thymoma in our hospital between January 1999 and July 2015. Patients met one of these criteria: 1. Non-surgical treatment; 2. Initially unresectable or resected difficultly; 3. Not completely resected including palliative resection, biopsy or exploratory operation. OS (Overall survival), DSS (Disease-Specific Survival) and PFS (Progression-Free Survival) were estimated by the Kaplan-Meier method. Outcomes for patients treated with different treatments were compared using the Log-Rank test. Multivariate analysis was performed with the Cox proportional hazards model to analyze factors predictive of the outcome. There are 76 eligible patients, 13 of them lost to follow-up, 63 patients’ information is available for analysis. There are 38 patients received non-surgical treatment (Group 1), 17 patients were resected incompletely (Group 2), and 8 patients received neoadjuvant therapy followed by surgery (Group 3). The overall 5-year OS, DSS and PFS is 71.3%, 69.9% and 55.3%, OS among different groups are statistically significant (P=0.004, Table 1). The main failure pattern is regional recurrence, pleural not contiguous with thymus is the most common recurrence site (65.6%). Single factor analysis shows that there is statistical relation between surgical options and outcome (P=0.007), while age (P=0.713), tumor size (P=0.749) and invading sites (P=0.06) are not relative. Surgery is still an important prognostic factor of stage III-IV thymoma. Palliative operation or complete excision after neoadjuvant therapy can improve the outcome even initially unresectable. For the unresectable cases, positive and suitable comprehensive therapy can also receive satisfying result.Abstract TU_24_3556; Table 1OS (%)DSS (%)PFS (%)3-y5-y10-y3-y5-y10-y3-y5-y10-yNon-surgical Treatment81.162.020.383.358.723.178.646.47.7Incomplete Resection92.976.040.592.976.040.569.356.720.2Neoadjuvant Treatment100.0100.066.7100.0100.066.7100.085.757.1Total86.871.333.588.269.935.480.555.318.2P value0.0040.0170.005 Open table in a new tab
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