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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
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.
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.
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.
Lewis JE, Wick MR, Scheithauer BW, Bernatz PE, Taylor WF. Thymoma. A clinicopathologic review. Cancer. 1987;60:2727–43.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
National Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in Oncology: Thymomas and Thymic carcinomas (version 1.2014). http://www.nccn.org.
Conflict of interest
None declared.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kato, T., Iwano, S., Taniguchi, T. et al. 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. Gen Thorac Cardiovasc Surg 63, 343–348 (2015). https://doi.org/10.1007/s11748-015-0525-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-015-0525-z