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Prognostic Impact of Number of Organ Invasions in Patients with Surgically Resected Thymoma

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to explore the clinical implications and prognostic value of the number of organ/structure invasions (NOI) in patients with thymoma after curative surgical resection.

Methods

We retrospectively analyzed 306 consecutive Japanese patients with thymoma who underwent curative surgical resection. Tumor invasions of pericardium, mediastinal pleura, phrenic nerve, lung, and venous structures were examined histopathologically. Cases were classified into four subgroups according to NOI: group 0, no tumor invasion; group 1, tumor invasion into single organ/structure; group 2, tumor invasion of two organs/structures; group 3, invasion of three or more organs/structures. Associations with NOI and several clinical characteristics and their prognostic significance were analyzed.

Results

Pleural invasion was found in 100 cases (32.7%), lung invasion in 48 cases (15.7%), pericardial invasion in 46 cases (15%), phrenic nerve invasion in 29 (9.5%), and venous invasion in 22 cases (7.2%). NOI was classed as group 0 in 201 cases (65.0%), group 1 in 42 cases (13.7%), group 2 in 20 cases (6.5%), and group 3 in 43 cases (14.1%). Cases with higher NOI showed significantly worse relapse-free survival (RFS) and overall survival (OS). Cox’s proportional hazard model analysis also identified NOI as a prognostic factor affecting RFS and OS.

Conclusions

Cases with higher NOI of thymoma after radical surgical resection showed significantly worse recurrence rates and survival.

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Acknowledgement

Yasushi Shintani: Shionogi & Co., Ltd. (grant), ISHIHARA SANGYO KAISHA, LTD (grant).

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

    Soichiro Funaki MD, PhD, Naoko Ose MD, Takashi Kanou MD, PhD, Eriko Fukui MD, PhD, Kenji Kimura MD, PhD, Masato Minami MD, PhD & Yasushi Shintani MD, PhD

  2. General Thoracic Surgery, Osaka Toneyama Medical Center, Osaka, Japan

    Meinoshin Okumura MD, PhD

Authors
  1. Soichiro Funaki MD, PhD
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  2. Naoko Ose MD
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  3. Takashi Kanou MD, PhD
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  4. Eriko Fukui MD, PhD
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  5. Kenji Kimura MD, PhD
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  6. Masato Minami MD, PhD
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  7. Meinoshin Okumura MD, PhD
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  8. Yasushi Shintani MD, PhD
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Correspondence to Soichiro Funaki MD, PhD.

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Supplementary Information

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Supplementary file1 (DOCX 16 kb)

Supplementary Fig. 1: The WHO histopathological distribution according to NOI subgroups (TIF 666 kb)

10434_2022_11698_MOESM3_ESM.tif

Supplementary Fig. 2: Relapse-free survival curve of patients with thymoma after the complete resection, with individual organ invasion. a Pleural invasion, b lung invasion, c pericardial invasion, d BCV/SVC invasion, e phrenic nerve invasion. All p-values are <0.05 (TIF 175 kb)

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Funaki, S., Ose, N., Kanou, T. et al. Prognostic Impact of Number of Organ Invasions in Patients with Surgically Resected Thymoma. Ann Surg Oncol 29, 4900–4907 (2022). https://doi.org/10.1245/s10434-022-11698-8

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  • DOI: https://doi.org/10.1245/s10434-022-11698-8

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