Thymoma and inter-relationships between clinical variables: a multicentre study in 537 patients.
OBJECTIVE
In thymomas, the roles of Masaoka-Koga stage, histology and the presence of myasthenia gravis (MG) have been considered fundamental for patient management and outcomes. In this study, we retrospectively evaluated several clinical variables, with the aim of outlining their relationships and clinical/prognostic significance in resected thymoma patients.


METHODS
A retrospective search of our surgical database for patients operated on for thymoma in six Italian high-volume thoracic surgery centres between 2000 and 2011 was conducted. The following clinical variables were evaluated: Masaoka-Koga Stage, tumour histology, the presence of MG, other autoimmune syndromes or second tumours, the completeness of tumour resection and the development of recurrences.


RESULTS
Five hundred and thirty-seven (273 males-51%) were retrospectively included in this study. Our results indicate that: (i) MG correlates with early Masaoka-Koga stage and B-type thymoma; (ii) Stage III-IVa tumours correlate with B-type tumour; (iii) autoimmune paraneoplastic syndromes correlate with Stage I-II thymoma; (iv) second malignancies correlate with the absence of paraneoplastic disorders and weakly with B-type tumour and (v) overall survival was influenced by Masaoka-Koga stage and completeness of surgical resection.


CONCLUSIONS
In thymomas, Masaoka-Koga stage, histology, MG, other autoimmune syndromes and second malignancies are inter-related, but only Masaoka-Koga tumour stage, amid these clinical variables, has been demonstrated to be a strong prognostic indicator of survival.
Department of Thoracic Surgery, University of Torino, Torino, Italy pierluigi.filosso@unito.it.
Pier Luigi
PL
Filosso
Department of Thoracic Surgery, Fondazione Eleonora Lorillard Spencer Cenci, Policlinico 'Umberto I', University of Rome Sapienza, Rome, Italy.
Federico
F
Venuta
Department of Thoracic Surgery, University of Torino, Torino, Italy.
Alberto
A
Oliaro
Department of Thoracic Surgery, University of Torino, Torino, Italy.
Enrico
E
Ruffini
Department of Thoracic Surgery, Fondazione Eleonora Lorillard Spencer Cenci, 'S.Andrea Hospital', University of Rome Sapienza, Rome, Italy.
Erino Angelo
EA
Rendina
Unit of Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy.
Stefano
S
Margaritora
Unit of Thoracic Surgery, 'Amedeo Avogadro' University, Novara, Italy.
Caterina
C
Casadio
Unit of Thoracic Surgery, 'Santa Croce e Carle Hospital', Cuneo, Italy.
Alberto
A
Terzi
Unit of Thoracic Surgery, 'Amedeo Avogadro' University, Novara, Italy.
Ottavio
O
Rena
Department of Thoracic Surgery, Azienda Ospedaliera Santa Maria Nuova, IRCCS Reggio Emilia, Emilia, Italy.
Filippo
F
Lococo
Department of Thoracic Surgery, University of Torino, Torino, Italy.
Francesco
F
Guerrera
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis; D012189:Retrospective Studies; D013945:Thymoma / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D013953:Thymus Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D055815:Young Adult
Cancer; Myasthenia gravis; Paraneoplastic disorders; Pathology; Surgery; Thymoma; World Health Organization