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Comparison of clinical features and prognosis between thymoma alone and thymoma with myasthenia gravis
Wang Lihuan,Meng Shaolin,Wu Yong,Zhang Yuhai,Wang Wei,Song Lele,Li Yuemin
Department of Radiation Oncology (Wang LH,Meng SHL,Wu Y,Zhang YH,Song LL,Li YM),Department of Neurology (Wang W),No.309 Hospital of PLA,Beijing 100091,China;Graduate Division of Hebei North University,Zhangjiakou 075000,China (Wang LH)
AbstractObjective To investigate the clinicopathological features and prognosis in patients with thymoma and patients with thymoma and myasthenia gravis (MG). Methods A retrospective analysis was performed on the clinicopathological data of 161 patients pathologically diagnosed with thymoma alone or thymoma and MG from 2008 to 2014. In those patients, 128 had thymoma with MG and 33 had thymoma alone. The survival rates were calculated using the Kaplan-Meier method and analyzed using χ2 test or Fisher′s exact probability test. Results The mean age of onset was 45.2 years for patients with thymoma and MG and 48.5 years for patients with thymoma alone. In patients with thymoma and MG, 74.2% had a tumor diameter of ≤5 cm, while 75.8% of patients with thymoma alone had a tumor diameter of ≥5 cm. According to the Masaoka staging system, 78.1% of patients with thymoma and MG had stage Ⅰ+Ⅱ disease, while 51.1% of patients with thymoma alone had stage Ⅲ+Ⅳ disease. There was no significant difference in the 3-year overall survival (OS) rate between the two groups (98.1% vs. 81.8%, P=1.000). The 5-year OS rate was significantly higher in patients with thymoma and MG than in patients with thymoma alone (91.1% vs. 42.9%, P=0.000). In all patients, 140 patients with complete resection had significantly higher 3-and 5-year OS rates than 21 patients with incomplete resection (97.2% vs. 58.8%, P=0.000;92.7% vs. 25.0%, P=0.000). In patients with stage Ⅱ disease, there were no significant differences in the 3-or 5-year OS rates between patients with complete resection alone (n=25) and patients with complete resection and postoperative radiotherapy (n=25)(95% vs. 100%, P=1.000;86% vs. 100%, P=0.467). Conclusions Compared with patients with thymoma alone, patients with thymoma and MG have an earlier age of onset, substantially smaller tumor diameters, and earlier Masaoka stages. MG and complete resection are positive prognostic factors for patients with thymoma. Radiotherapy after complete resection can reduce the recurrence rate in patients with stage Ⅱ disease.
Fund:Wu Jieping Medical Foundation (320675014296);Capital Featured Clinical Application Research Projects (Z121107001012060)
Corresponding Authors:
Li Yuemin,Email:liyuemin224@sina.com
E-mail: liyuemin224@sina.com
Cite this article:
Wang Lihuan,Meng Shaolin,Wu Yong et al. Comparison of clinical features and prognosis between thymoma alone and thymoma with myasthenia gravis[J]. Chinese Journal of Radiation Oncology, 2016, 25(8): 829-833.
Wang Lihuan,Meng Shaolin,Wu Yong et al. Comparison of clinical features and prognosis between thymoma alone and thymoma with myasthenia gravis[J]. Chinese Journal of Radiation Oncology, 2016, 25(8): 829-833.
[1] Kumar N,Kumar R,Bera A,et al. Thymoma:clinical experience from a tertiary care institute from North India[J].J Cancer Res Ther,2013,9(2):235-239.DOI:10.4103/0973-1482.113364 [2] Romi F.Thymoma in myasthenia gravis:from diagnosis to treatment[J].Auto Dis,2011,2011:474512.DOI:10.4061/2011/474512 [3] Casey EM,Kiel PJ,Loehrer Sr PJ.Clinical management of thymoma patients[J].Hematol Oncol Clin North Am,2008,22(3):457-473.DOI:10.1016/i.hoc.2008.03.010 [4] Spaggiari L,Casiraghi M,Guarize J.Multidisciplinary treatment of malignant thymoma[J].Curr Opin Oncol,2012,24(2):117-122.DOI:10.1097/CCO.0b013e32834ea6bb [5] Travis W,Brambilla E,Müller-Hermelink H K,et al. World Health Organization classification of tumours. Pathology& genetics:tumours of the lung,pleura,thymus and heart[M].Lyon:IARC Press,2004 [6] Singh G,Rumende CM,Amin Z.Thymoma:diagnosis and treatment[J].Acta Med Indones,2011,43(1):74-78 [7] Detterbeck FC.Evaluation and treatment of stage Ⅰ and Ⅱ thymoma[J].J Thorac Oncol,2010,5(10 Suppl 4):S318-S322.DOI:10.1097/JTO.0b013e3181f20 dab [8] Detterbeck FC,Zeeshan A.Thymoma:current diagnosis and treatment[J].Chin Med J (Engl),2013,126(11):2186-2191.DOI:10.3760/cma.j.issn.0366-6999.20130177 [9] Aydiner A,Toker A,Sen F,et al. Association of clinical and pathological variables with survival in thymoma[J].Med Oncol,2012,29(3):2221-2228.DOI:10.1007/s12032-011-0101-z [10] Maggi L,Andreetta F,Antozzi C,et al. Thymoma-associated myasthenia gravis:outcome,clinical and pathological correlations in 197 patients on a 20-year experience[J].J Neuroimmunol,2008,201-202:237-244.DOI:10.1016/j.jneuroim.2008.07.012 [11] Vachlas K,Zisis C,Rontogianni D,et al. Thymoma and myasthenia gravis:clinical aspects and prognosis[J].Asian Cardiovasc Thorac Ann,2012,20(1):48-52.DOI:10.1177/0218492311433189 [12] Filosso P L,Venuta F,Oliaro A,et al. Thymoma and inter-relationships between clinical variables:a multicentre study in 537 patients[J].Eur J Cardiothorac Surg,2014,45(6):1020-1027.DOI:10.1093/ejcts/ezt567 [13] Venuta F,Rendina EA,Anile M,et al. Thymoma and thymic carcinoma[J].Gen Thorac Cardiovasc Surg,2012,60(1):1-12.DOI:10.1007/s11748-011-0814-0 [14] Margaritora S,Cesario A,Cusumano G,et al. Thirty-five-year follow-up analysis of clinical and pathologic outcomes of thymoma surgery[J].Ann Thorac Surg,2010,89(1):245-252.DOI:10.1016/j.athoracsur.2009.08.074 [15] Detterbeck F C,Parsons A M.Thymic tumors:a review of current diagnosis,classification,and treatment[J].Thorac Esoph Surg,2008,27(1):1589-1614.DOI:10.1016/B978-0-443-06861-4.50134-9 [16] Kondo K,Monden Y.Therapy for thymic epithelial tumors:a clinical study of 1,320 patients from Japan[J].Ann Thorac Surg,2003,76(3):878-884.DOI:10.1016/S0003-4975(03)00555-1 [17] Fernandes AT,Shinohara ET,Guo MY,et al. The role of radiation therapy in malignant thymoma:a surveillance,Epidemiology and end results database analysis[J].J Thorac Oncol,2010,5(9):1454-1460.DOI:10.1097/JTO.0b013e3181e8f345 [18] Chen YD,Feng QF,Lu HZ,et al. Role of adjuvant radiotherapy for stage Ⅱ thymoma after complete tumor resection[J].Int J Radiat Oncol Biol Phys,2010,78(5):1400-1406.DOI:10.1016/j.ijrobp.2009.09.066 [19] Chang JH,Kim HJ,Wu HG,et al. Postoperative radiotherapy for completely resected stage Ⅱ or Ⅲ thymoma[J].J Thorac Oncol,2011,6(7):1282-1286.DOI:10.1097/JTO.0b013e31821f9662
2016, Vol. 25 
