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General Thoracic and Cardiovascular Surgery

Published in:

01-06-2015 | Original Article

The contact length between the tumor contour and the lung on computed tomography is a risk factor for pleural recurrence after complete resection of thymoma

Authors: Taketo Kato, Shingo Iwano, Tetsuo Taniguchi, Koji Kawaguchi, Takayuki Fukui, Futoshi Ishiguro, Koichi Fukumoto, Shota Nakamura, Akihiro Hirakawa, Kohei Yokoi

Published in: General Thoracic and Cardiovascular Surgery | Issue 6/2015

Abstract

Objective

Among the perioperative findings which included patient characteristics and imaging, surgical, and pathological findings of the tumor, the risk factors for pleural recurrence (PR) after complete resection of thymoma were explored.

Methods

Fifty-three patients with Masaoka stage I to III thymoma who underwent complete resection, and five patients with stage IVa disease accompanied with pleural dissemination were analyzed. In these cohorts, the patients were divided into a non-recurrence (NR) group, PR group and stage IVa group. The maximum tumor diameter (TD) and the contact length between the tumor contour and the lung (CLTL) were measured at the maximum section of the tumor on axial computed tomography. A multivariate analysis including gender, age, TD, CLTL, tumor adhesion to the lung, Masaoka stage, and WHO histological type was performed to estimate risk factors for PR.

Results

The median follow-up period was 76.9 months. PR developed in six patients. The mean TDs were 44 mm in the NR group, 62 mm in the PR group and 73 mm in the stage IVa group, respectively. The mean CLTLs were 47, 90 and 96 mm, respectively. The CLTLs of the PR group were significantly longer than those of the NR group (p < 0.001), although the TDs were not significantly different between the two groups. The multivariate analysis indicated that CLTL was only a risk factor for PR (p = 0.046).

Conclusion

The CLTL was significantly associated with the PR after complete resection of thymoma.

Travis WD, Brambilla E, Müller-Hermelink HK, Harris CC. World Health Organization classification of tumours. Pathology and genetics of tumours of the lung, pleura, thymus and heart. Lyon: IARC Press; 2004.

Ruffini E, Filosso PL, Mossetti C, Bruna MC, Novero D, Lista P, et al. Thymoma: inter-relationships among World Health Organization histology, Masaoka staging and myasthenia gravis and their independent prognostic significance: a single-centre experience. Eur J Cardiothorac Surg. 2011;40:146–53.PubMedCrossRef

Regnard JF, Magdeleinat P, Dromer C, Dulmet E, de Montpreville V, Levi JF, et al. Prognostic factors and long-term results after thymoma resection: a series of 307 patients. J Thorac Cardiovasc Surg. 1996;112:376–84.PubMedCrossRef

Haniuda M, Morimoto M, Nishimura H, Kobayashi O, Yamanda T, Iida F. Adjuvant radiotherapy after complete resection of thymoma. Ann Thorac Surg. 1992;54:311–5.PubMedCrossRef

Lewis JE, Wick MR, Scheithauer BW, Bernatz PE, Taylor WF. Thymoma. A clinicopathologic review. Cancer. 1987;60:2727–43.PubMedCrossRef

Monden Y, Nakahara K, Iioka S, Nanjo S, Ohno K, Fujii Y, et al. Recurrence of thymoma: clinicopathological features, therapy, and prognosis. Ann Thorac Surg. 1985;39:165–9.PubMedCrossRef

Haniuda M, Kondo R, Numanami H, Makiuchi A, Machida E, Amano J. Recurrence of thymoma: clinicopathological features, re-operation, and outcome. J Surg Oncol. 2001;78:183–8.PubMedCrossRef

Okuda K, Yano M, Yoshino I, Okumura M, Higashiyama M, Suzuki K, et al. Thymoma patients with pleural dissemination: nationwide retrospective study of 136 cases in Japan. Ann Thorac Surg. 2014;97:1743–8.PubMedCrossRef

Blumberg D, Port JL, Weksler B, Delgado R, Rosai J, Bains MS, et al. Thymoma: a multivariate analysis of factors predicting survival. Ann Thorac Surg. 1995;60:908–13.PubMedCrossRef

10.

Gawrychowski J, Rokicki M, Gabriel A, Lackowska B, Czyzewski D. Thymoma–the usefulness of some prognostic factors for diagnosis and surgical treatment. Eur J Surg Oncol. 2000;26:203–8.PubMedCrossRef

11.

Wright CD, Wain JC, Wong DR, Donahue DM, Gaissert HA, Grillo HC, et al. Predictors of recurrence in thymic tumors: importance of invasion, World Health Organization histology, and size. J Thorac Cardiovas Surg. 2005;130:1413–21.CrossRef

12.

Kim DJ, Yang WI, Choi SS, Kim KD, Chung KY. Prognostic and clinical relevance of the World Health Organization schema for the classification of thymic epithelial tumors: a clinicopathologic study of 108 patients and literature review. Chest. 2005;127:755–61.PubMedCrossRef

13.

Safieddine N, Liu G, Cuningham K, Ming T, Hwang D, Brade A, et al. Prognostic factors for cure, recurrence and long-term survival after surgical resection of thymoma. J Thorac Oncol. 2014;9:1018–22.PubMedCrossRef

14.

Park MS, Chung KY, Kim KD, Yang WI, Chung JH, Kim YS, et al. Prognosis of thymic epithelial tumors according to the new World Health Organization histologic classification. Ann Thorac Surg. 2004;78:992–7.PubMedCrossRef

15.

Wilkins KB, Sheikh E, Green R, Patel M, George S, Takano M, et al. Clinical and pathologic predictors of survival in patients with thymoma. Ann Surg. 1999;230:562–72.PubMedCentralPubMedCrossRef

16.

Haniuda M, Miyazawa M, Yoshida K, Oguchi M, Sakai F, Izuno I, et al. Is postoperative radiotherapy for thymoma effective? Ann Surg. 1996;224:219–24.PubMedCentralPubMedCrossRef

17.

Rea F, Marulli G, Girardi R, Bortolotti L, Favaretto A, Galligioni A, et al. Long-term survival and prognostic factors in thymic epithelial tumours. Eur J Cardiothorac Surg. 2004;26:412–8.PubMedCrossRef

18.

National Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in Oncology: Thymomas and Thymic carcinomas (version 1.2014). http://www.nccn.org.

Title: The contact length between the tumor contour and the lung on computed tomography is a risk factor for pleural recurrence after complete resection of thymoma
Authors: Taketo Kato
Shingo Iwano
Tetsuo Taniguchi
Koji Kawaguchi
Takayuki Fukui
Futoshi Ishiguro
Koichi Fukumoto
Shota Nakamura
Akihiro Hirakawa
Kohei Yokoi
Publication date: 01-06-2015
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 6/2015
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-015-0525-z

At a glance: The STEP trials

Springer Medicine

The contact length between the tumor contour and the lung on computed tomography is a risk factor for pleural recurrence after complete resection of thymoma

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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