FAN Cheng-cheng*,FENG Qin-fu, MAO You-sheng, CHEN Yi-dong, ZHAI Yi-rui, ZHANG Hong-xing, CHEN Dong-fu, XIAO Ze-fen, LI Jian, ZHOU Zong-mei, LIANG Jun, L Ji-ma, HUI Zhou-guang, WANG L-hua, He Jie
*Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021,China Corresponding author:FENG Qin-fu,Email:qinfufeng@yahoo.com.cn
Abstract：Objective To analyze survival and recurrence rates of patients with Masaoka stage Ⅲ thymoma and to explore the prognostic factors. Methods Between September 1965 and December 2010, a total of 111 patients with stage Ⅲ thymoma treated in our hospital were retrospectively analyzed. Sixty-eight patientsreceived complete resection±radiotherapy, while 23 patients received incomplete resection±radiotherapy and 20 patients received biopsy±radiotherapy. Eighty-seven patients received postoperative radiotherapy (12 patients received preoperative radiotherapy) while 24 patients received surgery alone. Results The median follow-up time was 66 months (5－540) with a follow-up rate of 92.5%(111/120). Compared with incomplete resection±radiotherapy and biopsy±radiotherapy, the 5-year overall survival (OS)(88% vs.59% and 57%,χ2=12.11,P=0.002),disease free survival (DFS)(74% vs.40% and 41%,χ2=11.49,P=0.003) and disease specific survival (DSS)(94% vs.69% and 60%,χ2=10.95,P=0.004) could be improved with complete resected±radiotherapy. Compared with surgery alone, postoperative radiotherapy did not improve OS,DFS and DSS (55% vs.77%(χ2=1.01,P=0.316),61% vs.61%(χ2=0.12,P=0.729) and 72% vs.85%(χ2=0.27,P=0.601), respectively). For the 68 patients received complete resection, radiotherapy after complete resection (56 patients) did not improve OS,DFS and DSS (82% vs.89%(χ2=0.31,P=0.576), 72% vs.81%(χ2=0.05,P=0.819) and 89%vs.95%(χ2=0.05,P=0.825), respectively) compared with surgery alone (8 patients). ConclusionsStage Ⅲ thymoma patients received complete resection had better outcome than patients received incomplete resection or biopsied only. The role of postoperative radiotherapy is still controversial for stage Ⅲ thymoma, randomized clinical trial is needed
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