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Lobulated tumor contour as a predictor of preoperative tumor invasion of the lung or pericardium in thymoma patients

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Abstract

Purpose

Preoperative investigations to detect invasion to neighboring organs are important for deciding on the most appropriate surgical approach for thymoma. We evaluated preoperative computed tomography (CT) findings in thymoma patients to identify the CT features associated with tumor invasion.

Methods

Clinicopathologic information on 193 patients who underwent surgical resection for thymoma at Chiba University Hospital between 2002 and 2016 was collected retrospectively. The surgical pathology identified invasion of thymoma in 35 patients: in the lung (n = 18), pericardium (n = 11), or both (n = 6). Contact lengths between the tumor contour and lung (CLTL) or pericardium (CLTP) were measured at the maximum section of the tumor on axial CT. Univariate and multivariate analyses were performed to analyze the relationship between pathological invasion of the lung or pericardium and the clinicopathologic features.

Results

The mean CLTL and CLTP were significantly longer in patients with invasion of the neighboring organs than in those without invasion. A lobulated tumor contour was identified in 95.6% of the patients with invasion of the neighboring organs. A multivariate analysis revealed that a lobulated tumor contour was significantly associated with both lung and pericardial invasion.

Conclusions

A lobulated tumor contour was significantly associated with lung and/or pericardial invasion in thymoma patients.

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Abbreviations

CT:

Computed tomography

CLTL:

Contact lengths between the tumor contour and lung

CLTP:

Contact lengths between the tumor contour and pericardium

WHO:

World Health Organization

ROC:

Receiver operating characteristic

AUC:

Area under curve

OS:

Overall survival

RFS:

Relapse-free survival

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Acknowledgements

We thank Brian Quinn from Japan Medical Communication for editing a draft of this manuscript.

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Author notes

  1. Kazuhisa Tanaka and Hidemi Suzuki contributed equally.

Authors and Affiliations

  1. Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chiba, 260-8670, Japan

    Kazuhisa Tanaka, Hidemi Suzuki, Terunaga Inage, Takamasa Ito, Yuichi Sakairi & Ichiro Yoshino

Authors
  1. Kazuhisa Tanaka
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  2. Hidemi Suzuki
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  3. Terunaga Inage
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  4. Takamasa Ito
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  5. Yuichi Sakairi
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  6. Ichiro Yoshino
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Contributions

Kazuhisa Tanaka, Hidemi Suzuki, Terunaga Inage, Takamasa Ito, Yuichi Sakairi, and Ichiro Yoshino were involved in the study design and data interpretation. Kazuhisa Tanaka, Hidemi Suzuki, and Ichiro Yoshino were involved in the data analysis. All the authors critically revised the report, commented on drafts of the manuscript, and approved the final report.

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Correspondence to Hidemi Suzuki.

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Tanaka, K., Suzuki, H., Inage, T. et al. Lobulated tumor contour as a predictor of preoperative tumor invasion of the lung or pericardium in thymoma patients. Surg Today 54, 162–167 (2024). https://doi.org/10.1007/s00595-023-02719-4

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  • DOI: https://doi.org/10.1007/s00595-023-02719-4

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