Prognostic Indicators After Surgery for Thymoma

Ikenna Okereke, Kenneth A. Kesler, Mohamed H. Morad, Deming Mi, Karen M. Rieger, Thomas J. Birdas, Sunil Badve, John D. Henley, Mark W. Turrentine, Robert P. Nelson, Patrick J. Loehrer

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background: We undertook a 20-year retrospective institutional study to investigate prognostic indicators after surgery for thymoma. Methods: From 1989 to 2009, 83 patients underwent surgical resection of thymoma or thymic carcinoma at our institution. Twelve of these patients were determined to have either World Health Organization type C disease or Masaoka stage IV-B disease and were excluded from analysis. The remaining 71 patients were reviewed. Results: The majority of patients in this series were female 64.7% (n = 46) with an overall average age of 51.0 years. The distribution of Masaoka stages I, II, III, and IV-A was 40.8% (n = 29), 19.7% (n = 14), 18.3% (n = 13), and 21.1% (n = 15), respectively. Thirteen of the 28 (46.2%) patients who presented with stage III or IV-A disease received preoperative chemotherapy. After a mean follow-up of 66 months (range, 6 to 241 months), 54 (75.3%) patients are alive and well while six are alive with disease. Eleven (16.0%) patients have died, but only 3 (4.3%) of these patients died of thymoma. The overall disease-specific survival was 97% and 89% at 5 and 10 years. Of the variables analyzed, only age was predictive of overall survival (p = 0.03). Masaoka stages I to III as compared with stage IV-A was significantly predictive of disease-free survival (p <0.01). Conclusions: Long-term disease-specific survival can be expected not only after surgery for early stage thymoma but also after surgery for advanced disease, including patients with pleural metastases. However, patients who undergo surgery for stage IV-A disease have reduced disease-free survival. Late mortality due to secondary cancers and associated immunologic disorders was more frequent than mortality from thymoma in this series.

Original languageEnglish (US)
Pages (from-to)1071-1079
Number of pages9
JournalAnnals of Thoracic Surgery
Volume89
Issue number4
DOIs
StatePublished - Apr 2010
Externally publishedYes

Fingerprint

Thymoma
Disease-Free Survival
Survival
Mortality
Retrospective Studies
Neoplasm Metastasis
Drug Therapy

ASJC Scopus subject areas

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

Cite this

Okereke, I., Kesler, K. A., Morad, M. H., Mi, D., Rieger, K. M., Birdas, T. J., ... Loehrer, P. J. (2010). Prognostic Indicators After Surgery for Thymoma. Annals of Thoracic Surgery, 89(4), 1071-1079. https://doi.org/10.1016/j.athoracsur.2010.01.026

Prognostic Indicators After Surgery for Thymoma. / Okereke, Ikenna; Kesler, Kenneth A.; Morad, Mohamed H.; Mi, Deming; Rieger, Karen M.; Birdas, Thomas J.; Badve, Sunil; Henley, John D.; Turrentine, Mark W.; Nelson, Robert P.; Loehrer, Patrick J.

In: Annals of Thoracic Surgery, Vol. 89, No. 4, 04.2010, p. 1071-1079.

Research output: Contribution to journalArticle

Okereke, I, Kesler, KA, Morad, MH, Mi, D, Rieger, KM, Birdas, TJ, Badve, S, Henley, JD, Turrentine, MW, Nelson, RP & Loehrer, PJ 2010, 'Prognostic Indicators After Surgery for Thymoma', Annals of Thoracic Surgery, vol. 89, no. 4, pp. 1071-1079. https://doi.org/10.1016/j.athoracsur.2010.01.026
Okereke I, Kesler KA, Morad MH, Mi D, Rieger KM, Birdas TJ et al. Prognostic Indicators After Surgery for Thymoma. Annals of Thoracic Surgery. 2010 Apr;89(4):1071-1079. https://doi.org/10.1016/j.athoracsur.2010.01.026
Okereke, Ikenna ; Kesler, Kenneth A. ; Morad, Mohamed H. ; Mi, Deming ; Rieger, Karen M. ; Birdas, Thomas J. ; Badve, Sunil ; Henley, John D. ; Turrentine, Mark W. ; Nelson, Robert P. ; Loehrer, Patrick J. / Prognostic Indicators After Surgery for Thymoma. In: Annals of Thoracic Surgery. 2010 ; Vol. 89, No. 4. pp. 1071-1079.
@article{8280f2bfe7464702abc0b407b42a03f7,
title = "Prognostic Indicators After Surgery for Thymoma",
abstract = "Background: We undertook a 20-year retrospective institutional study to investigate prognostic indicators after surgery for thymoma. Methods: From 1989 to 2009, 83 patients underwent surgical resection of thymoma or thymic carcinoma at our institution. Twelve of these patients were determined to have either World Health Organization type C disease or Masaoka stage IV-B disease and were excluded from analysis. The remaining 71 patients were reviewed. Results: The majority of patients in this series were female 64.7{\%} (n = 46) with an overall average age of 51.0 years. The distribution of Masaoka stages I, II, III, and IV-A was 40.8{\%} (n = 29), 19.7{\%} (n = 14), 18.3{\%} (n = 13), and 21.1{\%} (n = 15), respectively. Thirteen of the 28 (46.2{\%}) patients who presented with stage III or IV-A disease received preoperative chemotherapy. After a mean follow-up of 66 months (range, 6 to 241 months), 54 (75.3{\%}) patients are alive and well while six are alive with disease. Eleven (16.0{\%}) patients have died, but only 3 (4.3{\%}) of these patients died of thymoma. The overall disease-specific survival was 97{\%} and 89{\%} at 5 and 10 years. Of the variables analyzed, only age was predictive of overall survival (p = 0.03). Masaoka stages I to III as compared with stage IV-A was significantly predictive of disease-free survival (p <0.01). Conclusions: Long-term disease-specific survival can be expected not only after surgery for early stage thymoma but also after surgery for advanced disease, including patients with pleural metastases. However, patients who undergo surgery for stage IV-A disease have reduced disease-free survival. Late mortality due to secondary cancers and associated immunologic disorders was more frequent than mortality from thymoma in this series.",
author = "Ikenna Okereke and Kesler, {Kenneth A.} and Morad, {Mohamed H.} and Deming Mi and Rieger, {Karen M.} and Birdas, {Thomas J.} and Sunil Badve and Henley, {John D.} and Turrentine, {Mark W.} and Nelson, {Robert P.} and Loehrer, {Patrick J.}",
year = "2010",
month = "4",
doi = "10.1016/j.athoracsur.2010.01.026",
language = "English (US)",
volume = "89",
pages = "1071--1079",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Prognostic Indicators After Surgery for Thymoma

AU - Okereke, Ikenna

AU - Kesler, Kenneth A.

AU - Morad, Mohamed H.

AU - Mi, Deming

AU - Rieger, Karen M.

AU - Birdas, Thomas J.

AU - Badve, Sunil

AU - Henley, John D.

AU - Turrentine, Mark W.

AU - Nelson, Robert P.

AU - Loehrer, Patrick J.

PY - 2010/4

Y1 - 2010/4

N2 - Background: We undertook a 20-year retrospective institutional study to investigate prognostic indicators after surgery for thymoma. Methods: From 1989 to 2009, 83 patients underwent surgical resection of thymoma or thymic carcinoma at our institution. Twelve of these patients were determined to have either World Health Organization type C disease or Masaoka stage IV-B disease and were excluded from analysis. The remaining 71 patients were reviewed. Results: The majority of patients in this series were female 64.7% (n = 46) with an overall average age of 51.0 years. The distribution of Masaoka stages I, II, III, and IV-A was 40.8% (n = 29), 19.7% (n = 14), 18.3% (n = 13), and 21.1% (n = 15), respectively. Thirteen of the 28 (46.2%) patients who presented with stage III or IV-A disease received preoperative chemotherapy. After a mean follow-up of 66 months (range, 6 to 241 months), 54 (75.3%) patients are alive and well while six are alive with disease. Eleven (16.0%) patients have died, but only 3 (4.3%) of these patients died of thymoma. The overall disease-specific survival was 97% and 89% at 5 and 10 years. Of the variables analyzed, only age was predictive of overall survival (p = 0.03). Masaoka stages I to III as compared with stage IV-A was significantly predictive of disease-free survival (p <0.01). Conclusions: Long-term disease-specific survival can be expected not only after surgery for early stage thymoma but also after surgery for advanced disease, including patients with pleural metastases. However, patients who undergo surgery for stage IV-A disease have reduced disease-free survival. Late mortality due to secondary cancers and associated immunologic disorders was more frequent than mortality from thymoma in this series.

AB - Background: We undertook a 20-year retrospective institutional study to investigate prognostic indicators after surgery for thymoma. Methods: From 1989 to 2009, 83 patients underwent surgical resection of thymoma or thymic carcinoma at our institution. Twelve of these patients were determined to have either World Health Organization type C disease or Masaoka stage IV-B disease and were excluded from analysis. The remaining 71 patients were reviewed. Results: The majority of patients in this series were female 64.7% (n = 46) with an overall average age of 51.0 years. The distribution of Masaoka stages I, II, III, and IV-A was 40.8% (n = 29), 19.7% (n = 14), 18.3% (n = 13), and 21.1% (n = 15), respectively. Thirteen of the 28 (46.2%) patients who presented with stage III or IV-A disease received preoperative chemotherapy. After a mean follow-up of 66 months (range, 6 to 241 months), 54 (75.3%) patients are alive and well while six are alive with disease. Eleven (16.0%) patients have died, but only 3 (4.3%) of these patients died of thymoma. The overall disease-specific survival was 97% and 89% at 5 and 10 years. Of the variables analyzed, only age was predictive of overall survival (p = 0.03). Masaoka stages I to III as compared with stage IV-A was significantly predictive of disease-free survival (p <0.01). Conclusions: Long-term disease-specific survival can be expected not only after surgery for early stage thymoma but also after surgery for advanced disease, including patients with pleural metastases. However, patients who undergo surgery for stage IV-A disease have reduced disease-free survival. Late mortality due to secondary cancers and associated immunologic disorders was more frequent than mortality from thymoma in this series.

UR - http://www.scopus.com/inward/record.url?scp=77949553621&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77949553621&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2010.01.026

DO - 10.1016/j.athoracsur.2010.01.026

M3 - Article

VL - 89

SP - 1071

EP - 1079

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 4

ER -