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Tumor size exceeding 5 cm as a valid prognostic factor in all stages of thymic epithelial tumors

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A Correction to this article was published on 25 September 2022

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Abstract

Purpose

This study investigated the prognostic factors of thymic epithelial tumors (TETs) to identify patients who require multidisciplinary treatment and improve the TET prognosis.

Methods

We retrospectively reviewed the data of 268 TET patients. Prognostic variables for the overall survival (OS) were analyzed in all TET stages (n = 268), and the recurrence-free survival (RFS) was analyzed in patients who achieved complete resection (n = 164).

Results

The median follow-up period was 7 years; thymic carcinomas (TCs) and advanced stages of tumor, node, and metastasis (TNM) classification had the worse prognosis according to a Kaplan–Meier analysis. The cut-off value of the tumor size to predict the OS and RFS was determined using modified Harrell’s c-index calculated by a Cox regression analysis of the OS. Regarding the OS, a multivariate analysis revealed that age > 70 years old (p = 0.011), tumor size > 5 cm (p < 0.001), and TCs (p = 0.002) were significant prognostic factors aside from the TNM stage (p < 0.001). Regarding the RFS, tumor size > 5 cm was the only significant prognostic factor in the multivariate analysis (p = 0.002) aside from the TNM stage (p = 0.008).

Conclusions

Tumor size > 5 cm was shown to be a prognostic predictor in addition to the WHO and TNM classifications. Therefore, multidisciplinary treatment should be developed for TET patients with poor prognostic factors, specifically tumor size.

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Acknowledgements

We would like to thank Mari S. OBA Ph.D. of the Department of Medical Statistics Faculty of Medicine, Toho University, for assisting with the statistical analysis.

Funding

No grant or administrative support was provided for this study. No funder had any involvement regarding study design; collection, analysis, or interpretation of the data; writing of the report; or decision to submit the report for publication.

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Authors and Affiliations

  1. Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Takashi Sakai, Keiju Aokage, Tomohiro Miyoshi, Kenta Tane & Masahiro Tsuboi

  2. Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, Ota, Tokyo, Japan

    Takashi Sakai

  3. Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Kashiwa, Japan

    Genichiro Ishii

  4. Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan

    Koichi Goto

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  1. Takashi Sakai
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Correspondence to Keiju Aokage.

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Sakai, T., Aokage, K., Miyoshi, T. et al. Tumor size exceeding 5 cm as a valid prognostic factor in all stages of thymic epithelial tumors. Surg Today 53, 42–50 (2023). https://doi.org/10.1007/s00595-022-02530-7

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