The role of surgical management in recurrent thymic tumors

Masatsugu Hamaji, Mark S. Allen, Stephen D. Cassivi, Francis C. Nichols, Dennis A. Wigle, Claude Deschamps, K. Robert Shen

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Background: There are few data on outcomes after surgical treatment for recurrent thymic tumors. The aim of this study is to analyze and compare long-term outcomes of treatments for recurrent thymic tumors. Methods: Between January 1956 and December 2009, 344 thymic tumors were surgically resected (309 thymomas, 22 thymic carcinomas, 12 thymic carcinoids, and 1 thymolipoma). There were 48 recurrences (13.9%): 30 thymomas, 9 thymic carcinomas, and 9 thymic carcinoids. There were 27 men and 21 women with a median age of 51 years (range, 27 to 83). Retrospective chart review was performed. Relevant factors for recurrence as well as survival and progression-free interval were analyzed. Results: The median follow-up interval from the initial operation was 83 months (range, 9 to 515). Recurrence adversely affected overall survival in surgically resected thymic tumors (p = 0.0014). In multivariate analysis, the initial Masaoka stage, incomplete resection, and World Health Organization histology were significant risk factors for recurrence. In multivariate analysis, only surgical management was associated with prolonged survival p = 0.0038) and improved progression-free interval (p = 0.0378) in recurrent thymoma. Five-year survival after recurrent thymoma was 54%. For recurrent thymic carcinoma, surgery did not improve survival. For these patients, chemotherapy was associated with improved progression-free interval after recurrence (p = 0.0295). There were no 5-year survivors of recurrent thymic carcinoma. Conclusions: Our data suggest that surgical management is associated with better outcome and is the treatment of choice for recurrent thymoma. For recurrent thymic carcinoma, surgical management has a very limited role, and chemotherapy appears to be a more effective treatment modality.

Original languageEnglish (US)
Pages (from-to)247-254
Number of pages8
JournalAnnals of Thoracic Surgery
Volume94
Issue number1
DOIs
StatePublished - Jul 1 2012

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Hamaji, M., Allen, M. S., Cassivi, S. D., Nichols, F. C., Wigle, D. A., Deschamps, C., & Shen, K. R. (2012). The role of surgical management in recurrent thymic tumors. Annals of Thoracic Surgery, 94(1), 247-254. https://doi.org/10.1016/j.athoracsur.2012.02.092