Background In this study, we evaluated if surgical treatment and iterative operations could confer a survival advantage for patients with recurrent or repeated recurrences of thymoma. Methods Between 1984 and 2014, 53 of 515 (10%) patients had recurrences after complete thymoma resection. Demographics, stage, treatment, and pathologic findings were statistically analyzed to identify survival prognostic factors. Results Thirty-eight of 53 (72%) patients underwent resection of recurrent thymoma; 32 (84%) underwent complete resection. Fifteen (28%) patients did not undergo resection; 3 (20%) received chemotherapy alone, 10 (67%) received chemoradiotherapy, and 2 (13%) received supportive care. At univariate analysis, World Health Organization (WHO) AB + B1 histologic types (p < 0.0001), R0 resection (p < 0.0001), myasthenia gravis (MG) (p = 0.02), and adjuvant therapy after recurrence (p = 0.03) were significant prognostic factors. At multivariate analysis, complete resection (p = 0.0003) was the only significant prognostic factor. Among patients with repeated resections, those undergoing complete resection had better survival than did those undergoing incomplete resection or no operative procedure (p = 0.02). Seven patients are alive and free of disease, with a median survival of 115 months (70–161 months) and 149 months (61–201 months) from the first recurrence and from thymoma resection, respectively. Conclusions Complete resection is a viable treatment option for selected patients with recurrent thymomas. In cases of technically resectable repeated recurrences, repeated operations should be considered.
Iterative Surgical Treatment for Repeated Recurrences After Complete Resection of Thymic Tumors
VANNUCCI, JACOPO;PUMA, Francesco;
2017
Abstract
Background In this study, we evaluated if surgical treatment and iterative operations could confer a survival advantage for patients with recurrent or repeated recurrences of thymoma. Methods Between 1984 and 2014, 53 of 515 (10%) patients had recurrences after complete thymoma resection. Demographics, stage, treatment, and pathologic findings were statistically analyzed to identify survival prognostic factors. Results Thirty-eight of 53 (72%) patients underwent resection of recurrent thymoma; 32 (84%) underwent complete resection. Fifteen (28%) patients did not undergo resection; 3 (20%) received chemotherapy alone, 10 (67%) received chemoradiotherapy, and 2 (13%) received supportive care. At univariate analysis, World Health Organization (WHO) AB + B1 histologic types (p < 0.0001), R0 resection (p < 0.0001), myasthenia gravis (MG) (p = 0.02), and adjuvant therapy after recurrence (p = 0.03) were significant prognostic factors. At multivariate analysis, complete resection (p = 0.0003) was the only significant prognostic factor. Among patients with repeated resections, those undergoing complete resection had better survival than did those undergoing incomplete resection or no operative procedure (p = 0.02). Seven patients are alive and free of disease, with a median survival of 115 months (70–161 months) and 149 months (61–201 months) from the first recurrence and from thymoma resection, respectively. Conclusions Complete resection is a viable treatment option for selected patients with recurrent thymomas. In cases of technically resectable repeated recurrences, repeated operations should be considered.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.