Abstract
Thymomas are relatively slow growing with late presentation. Because of rarity and underreporting in India, there is an unmet need for evaluating the patient characteristics and assessing the factors affecting survival for standardizing the ideal modality of treatment in Indian population. A retrospective analysis of 96 patients with thymoma was done between 1998 and 2018. Patient characteristics, histopathological characteristics, operative outcomes, local recurrences, and survival outcomes were recorded. Survival analysis was done using Kaplan-Meier method, and statistical data were analyzed using SPSS version 25 (IBM). The incidence of thymoma was relatively high in 6th decade with no sex predilection. Common presenting symptoms were cough and dyspnea. Myasthenia gravis was noted in 30.2%, which resolved after thymectomy in 65.5% of patients. Most patients presented with Masaoka stages I and II, and predominant WHO histological types were B1 and AB. Complete resection was done in 69.8% cases, and local recurrence was noted in 15.6%. Median sternotomy was the most frequently used approach for thymectomy. The 5-year overall survival was 76%, with an excellent 5-year survival of 95% and 86% in stages I and II patients. Masaoka stage, WHO histologic type, completeness of surgery, and local recurrence did affect the survival significantly. Masaoka stages III and IV, histological type B3, incomplete resection during surgery, and presence of local recurrence did independently predict a worse overall survival.
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Venuta F, Anile M, Diso D, Vitolo D, Rendina EA, de Giacomo T, Francioni F, Coloni GF (2010) Thymoma and thymic carcinoma. Eur J Cardiothorac Surg 37(1):13–25
Weis CA, Yao X, Deng Y, Detterbeck FC, Marino M, Nicholson AG, Huang J, Ströbel P, Antonicelli A, Marx A, Contributors to the ITMIG Retrospective Database (2015) The impact of thymoma histotype on prognosis in a worldwide database. J Thorac Oncol 10(2):367–372
Zhu G, He S, Fu X, Jiang G, Liu T (2004) Radiotherapy and prognostic factors for thymoma: a retrospective study of 175 patients. Int J Radiat Oncol Biol Phys 60(4):1113–1119
Bian D, Zhou F, Yang W, Zhang K, Chen L, Jiang G, Zhang P, Wu C, Fei K, Zhang L (2018) Thymoma size significantly affects the survival, metastasis and effectiveness of adjuvant therapies: a population based study. Oncotarget 9(15):12273–12283
Gripp S, Hilgers K, Wurm R, Schmitt G (1998) Thymoma: prognostic factors and treatment outcomes. Cancer 83(8):1495–1503
Zhao M, Yin J, Yang X, Jiang T, Lu T, Huang Y, Li M, Yang X, Lin M, Niu H, Zhan C, Feng M, Wang Q (2019) Nomogram to predict thymoma prognosis: a population-based study of 1312 cases. Thoracic cancer 10(5):1167–1175
Kumar N, Kumar R, Bera A et al (2013) Thymoma: clinical experience from a tertiary care institute from North India. J Cancer Res Ther 9:235–239
Rathod S, Munshi A, Paul S, Ganesh B, Prabhash K, Agarwal JP (2014) Thymoma: first large Indian experience. Indian J Cancer 51:109–112
Arjunan R, Kurpad V, Prakash V et al (2015) Thymoma: a retrospective review of 55 cases of thymoma treated at a regional cancer center. J Cancer Prev Curr Res 2(1):00025
Shamsuddin F, Khadilkar UN, Saha D, Sreedharan S (2015) A clinicopathologic study of mediastinal lesions with special emphasis on thymomas. Int J Res Med Sci 3:1902–1910
Julka PK, Sharma DN, Mallick S, Gandhi AK, Joshi NP, Haresh KP, Gupta S, Rath GK (2017) Outcomes of thymoma treated with multimodality approach: a tertiary cancer center experience of 71 patients. Tumori 103:572–576
Vaideeswar P, Padmanabhan A, Deshpande JR, Pandit SP (2004) Thymoma: a pathological study of 50 cases. J Postgrad Med 50:94–97
Sundaram C, Rajagopal P, Rakshak AD, Omprakash G, Das SM, Murthy JM (2003) Clinicopathological study of thymomas – correlation of histologic subtype to myasthenia gravis and prognosis. Indian J Pathol Microbiol 46:378–381
Guleria P, Parshad R, Malik PS et al (2019) Histotyping of Indian thymomas: a clinicopathologic study from North India. Indian J Med Res 150:153–160
Roden AC, Yi ES, Jenkins SM, Edwards KK, Donovan JL, Cassivi SD, Marks RS, Garces YI, Aubry MC (2015) Modified Masaoka stage and size are independent prognostic predictors in thymoma and modified Masaoka stage is superior to histopathologic classifications. J Thorac Oncol 10(4):691–700
Lee WS, Heo DS, Bang YJ, Lee KS, Ahn JS, Jung CW, Han SK, Sung SW, Kim JH, Shim YS, Park CI, Kim NK (1996) Prognostic factors of patients with thymoma. Korean J Intern Med 11(1):40–49
Koçer B, Kaplan T, Günal N, Koçer BG, Akkaş Y, Yazkan R, Dural K, Kulaçoğlu S, Han S (2018) Long-term survival after R0 resection of thymoma. Asian Cardiovasc Thorac Ann 26(6):461–466
Hamaji M, Ali SO, Burt BM (2015) A meta-analysis of induction therapy for advanced thymic epithelial tumors. Ann Thorac Surg 99(5):1848–1856
Pirronti T, Rinaldi P, Batocchi AP, Evoli A, di Schino C, Marano P (2002) Thymic lesions and myasthenia gravis. Diagnosis based on mediastinal imaging and pathological findings. Acta Radiol 43(4):380–384
Blossom GB, Ernstoff RM, Howells GA, Bendick PJ, Glover JL (1993) Thymectomy for myasthenia gravis. Arch Surg 128(8):855–862
Zhang Y, Yu L, Jing Y, Ke J (2015) The relationship between myasthenia gravis and the different pathological type of thymoma patients’ operation and prognosis. Zhonghua Wai Ke Za Zhi 53(8):612–616
Wang F, Pang L, Fu J, Shen Y, Wei Y, Tan L, Zhang P, Han Y, Chen C, Zhang R, Li Y, Chen K, Chen H, Liu Y, Cui Y, Wang Y, Yu Z, Zhou X, Liu Y, Liu Y, Gu Z, Fang W, Members of the Chinese Alliance for Research in Thymomas (2016) Postoperative survival for patients with thymoma complicating myasthenia gravis-preliminary retrospective results of the ChART database. J Thorac Dis 8(4):711–717
Masaoka A, Monden Y, Nakahara K, Tanioka T (1981) Follow-up study of thymomas with special reference to their clinical stages. Cancer 48(11):2485–2492
Strobel P, Bauer A, Puppe B et al (2004) Tumor recurrence and survival in patients treated for thymomas and thymic squamous cell carcinomas: a retrospective analysis. J Clin Oncol 22(8):1501–1509
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This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the IRB of Kidwai Memorial Institute of Oncology, who determined that our study did not need ethical approval.
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Dharanikota, A., Arjunan, R., Chowdappa, R. et al. Survival Outcomes in Patients with Thymoma after Thymectomy in an Indian Scenario. Indian J Surg Oncol 11, 785–790 (2020). https://doi.org/10.1007/s13193-020-01258-5
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DOI: https://doi.org/10.1007/s13193-020-01258-5