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Tumor perimeter and lobulation as predictors of pleural recurrence in patients with resected thymoma

 Young Woo Do  ;  Hye-Jeong Lee  ;  Kyoung Shik Narm  ;  Hee Suk Jung  ;  Jin Gu Lee  ;  Dae Joon Kim  ;  Kyung Young Chung  ;  Chang Young Lee 
 LUNG CANCER, Vol.98 : 79-83, 2016 
Journal Title
Issue Date
Adult ; Aftercare ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Pleural Neoplasms/diagnostic imaging* ; Pleural Neoplasms/mortality ; Pleural Neoplasms/secondary* ; Pleural Neoplasms/therapy ; Postoperative Period ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Risk Factors ; Thymoma/diagnostic imaging* ; Thymoma/mortality ; Thymoma/pathology* ; Thymoma/surgery ; Tomography, X-Ray Computed ; Tumor Burden
Pleural recurrence ; Radiologic parameters ; Thymoma
OBJECTIVES: Recurrence of resected thymoma frequently occurs during follow-up, with pleural recurrence as the most common type. The aim of our study was to identify risk factors for pleural recurrence after complete resection of thymoma by investigating clinical, radiological, surgical, and pathological findings.

MATERIALS AND METHODS: Retrospective study was performed with 309 patients who had undergone complete resection of thymoma between January 2000 and December 2013. Among these cases, the patients were divided into the no pleural recurrence group (n=285) and the pleural recurrence group (n=24). Radiologic parameters such as maximum tumor diameter, tumor perimeter that contacted the lung (TPCL) and lobulated tumor contour were measured based on computed tomography. A multivariate analysis was performed to estimate risk factors for pleural recurrence including maximum tumor diameter, TPCL, lobulated tumor contour, World Health Organization (WHO) histologic classification, and Masaoka-Koga (M-K) stage.

RESULTS: The median follow-up period was 62 months. The pleural recurrence rate was 7.8% (24/309). After univariate analysis, longer maximum tumor diameter (p<0.001), longer TPCL (p<0.001), lobulated tumor contour (p=0.001), WHO histologic type B2, B3 (p=0.002), and M-K stage III/IV (p<0.001) demonstrated significant differences with risk factors of pleural recurrence. Multivariate analysis revealed that TPCL (per 1cm increase: hazard ratio [HR]: 1.040, 95% confidence interval [CI]: 1.019-1.061, p<0.001), lobulated tumor contour (HR: 5.883, CI: 1.201-28.824, p=0.029), WHO histologic classification B2/B3 (HR: 5.331, CI: 1.453-19.558, p=0.012) and advanced M-K stage (HR: 3.900, CI: 1.579-9.632, p=0.003) were significantly associated with pleural recurrence.

CONCLUSION: TPCL and lobulated tumor contour as well as WHO histologic classification and M-K stage were independent predictors of pleural recurrence after thymoma resection. Our study demonstrated that radiologic parameters could be useful predictor of pleural recurrence in patients with resected thymoma.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Narm, Kyoung Shik(남경식)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Chung, Kyung Young(정경영)
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