Medicina pulmonar y respiratoria

Long-Term Outcomes of Recurrent Thymoma

Abstract

Cai Xu, Qinfu Feng, Zhouguang Hui, Chengcheng Fan, Yirui Zhai, Yidong Chen, Hongxing Zhang, Zefen Xiao, Jun Liang, Dongfu Chen, Zongmei Zhou, Miaoli Zheng, Xiaodan Wang, Lvhua Wang and Jie He

Background: This study sought to analyze the results and prognosis of recurrent thymoma. Methods: Between 1991 and 2012, 32 patients that developed recurring thymoma after radical resection at initial treatment were reviewed. Results: The median follow-up duration after initial treatment and recurrence was 89 and 49.5 months, respectively. The median recurrence free internal (RFI) was 42 months, and the 5-year overall survival (OS) rates following recurrence was 65.5% for recurrent thymoma. Among 32 patients that relapsed, 7 underwent reoperation, 18 experienced nonsurgical management, 5 failed to receive treatment, and 2 remain unknown. The 5-year OS rates after recurrence of the surgery plus adjuvant chemotherapy/radiotherapy group and the non-surgery group were 100% and 73.1%, respectively (P=0.210). Histological WHO upgrading was frequently observed (57.1%) in patients with recurrent thymoma who received reoperation. In univariate analysis, age (<55 years, P=0.009), local and regional recurrence (P=0.022), and late recurrence (RFI ≥ 20 months, P=0.038) indicated good prognostic factors of recurrent thymoma. Conclusions: Reoperation plus adjuvant chemotherapy/radiotherapy may result in good outcomes for patients who can tolerate surgery when complete resection is possible, and may get better results than non-surgery treatment. Histological WHO upgrade was frequently observed in recurrent thymoma. Age <55 years, local and regional recurrence, and longer RFI (RFI ≥ 20 months) were associated with a positive prognosis.