title: [Role of Postoperative Radiotherapy for Stage I/II/III Thymic Tumor - Results of the ChART Retrospective Database].
abstract: BACKGROUND
  Postoperative radiotherapy (PORT) for thymic tumor is still controversial. The object of the study is to evaluate the role of PORT for stage I/II/III thymic tumor.
  
  
  METHODS
  The database of Chinese Alliance of Research for Thymomas (ChART) was retrieved for patients with stage I/II/III thymic tumor who underwent surgical therapy without neoajuvant therapy between 1994 and 2012. Univariate and multivariate survival analyses were performed. Cox proportional hazard model was used to determine the hazard ratio for death.
  
  
  RESULTS
  1,546 stage I/II/III patients were identified from ChART database. Among these patients, 649 (41.98%) underwent PORT. PORT was associated with gender, histologic type (World Health Organization, WHO), surgical extent, complete resection, Masaoka stage and adjuvant chemotherapy. The 5-yr and 10-yr overall survival (OS) rates and disease-free survival (DFS) rate for patients underwent surgery followed by PORT were 90% and 80%, 81% and 63%, comparing with 96% and 95%, 92% and 90% for patients underwent surgery alone (P=0.001, P<0.001) respectively. In univariate analysis, age, histologic type (WHO), Masaoka stage, completeness of resection, and PORT were associated with OS. Multivariable analysis showed that histologic type (WHO)(P=0.001), Masaoka stage (P=0.029) and completeness of resection (P=0.003) were independently prognostic factors of OS. In univariate analysis, gender, myasthenia gravis, histologic type (WHO), Masaoka stage, surgical approach, PORT and completeness of resection were associated with DFS. Multivariable analysis showed that histologic type (WHO) (P<0.001), Masaoka stage (P=0.005) and completeness of resection (P=0.006) were independently prognostic factors of DFS. Subgroup analysis showed that patients with incomplete resection underwent PORT achieved the better OS and DFS (P=0.010, 0.017, respectively). However, patients with complete resection underwent PORT had the worse OS and DFS (P<0.001, P<0.001, respectively).
  
  
  CONCLUSIONS
  The current retrospective study indicated that PORT after incomplete resection could improve OS and DFS for patients with stage I/II/III thymic tumor. But for those after complete resection, PORT may not help improve prognosis on the whole. .
authors.affiliation: Department of Thoracic Surgery, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China.
authors.forename: Qianwen
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
authors.forename: Zhitao
authors.initials: Z
authors.lastname: Gu
authors.affiliation: Department of Thoracic Surgery, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China.
authors.forename: Fu
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Thoracic Surgery, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Fu
authors.affiliation: Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao 266001, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao 266001, China.
authors.forename: Yucheng
authors.initials: Y
authors.lastname: Wei
authors.affiliation: Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Lijie
authors.initials: L
authors.lastname: Tan
authors.affiliation: Department of Endocrinology, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu 610041, China.
authors.forename: Yongtao
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Thoracic Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Renquan
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Thoracic Surgery, Beijing Cancer Hospital, Beijing 100142, China.
authors.forename: Ke-Neng
authors.initials: KN
authors.lastname: Chen
authors.affiliation: Department of Cardiothoracic Surgery, Changhai Hospital, Shanghai 200433, China.
authors.forename: Hezhong
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Thoracic Surgery, Liaoning Cancer Hospital, Shenyang 110042, China.
authors.forename: Yongyu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, First Affiliated Hospital of Jilin University, Changchun 130021, China.
authors.forename: Youbing
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Liewen
authors.initials: L
authors.lastname: Pang
authors.affiliation: Department of Esophageal Cancer, Tianjin Cancer Hospital, Tianjin 300060, China.
authors.forename: Zhentao
authors.initials: Z
authors.lastname: Yu
authors.affiliation: Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China.
authors.forename: Xinming
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Thoracic Surgery, Jiangxi People's Hospital, Nanchang 330006, China.
authors.forename: Yangchun
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Xiang
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
authors.forename: Wentao
authors.initials: W
authors.lastname: Fang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care; D012189:Retrospective Studies; D015996:Survival Rate; D013945:Thymoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D013953:Thymus Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery