Assessment of multimodality therapy for thymoma.
BACKGROUND
This study was designed to analyze the accuracy and reliability of several prognostic indicators for long-term survival of thymoma patients.


METHODS
Data from 142 patients treated for thymoma at the Tianjin Medical University Cancer Hospital from January 1954 to January 2001 were retrospectively analyzed. The Kaplan-Meier method and Cox's proportional hazards model test were used for single and multi-variable analyses respectively. The Log-rank test was used to compare survival between groups.


RESULTS
The sizes and extent of the tumors were classified as I - IV according to the Masaoka clinical staging scale. Respective 5- and 10-year survival rates were: 93.8% and 79.2% in stage I, 79.3% and 55.2% in stage II, 53.1% and 34.4% in stage III, and no survivors in stage IV. Among 30 patients with associated myasthenia gravis, 19 had generalized myasthenia gravis and 11 had ocular myasthenia gravis; 5- and 10-year survival rates were 83.3% and 60.0%, respectively. The 5- and 10-year survival rates for 112 patients without myasthenia gravis were 53.6% and 42.0%, respectively. Eighty-four patients had radical resection and nine had palliative resection. Eighty-nine patients had radiotherapy and 55 patients had postoperative radiotherapy. Single or multi-variable analyses showed that the main prognostic indicators are Masaoka clinical staging, thymoma-associated myasthenia gravis, and the treatment method.


CONCLUSIONS
The most important indicators of long-term survival in thymoma are Masaoka clinical staging and the completeness of resection. The primary treatment method for thymoma should be wide tumor resection. Pre- and/or postoperative radio- and/or chemotherapy should be given according to individual treatment requirements.
Chen
Jie
J
Department of Radiotherapy, Tianjin Medical University Cancer Hospital, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin 300060, China. tjcjvip@126.com
Wang
Ping
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013945:Thymoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D013953:Thymus Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult