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The role of postoperative radiotherapy in stage II and III thymoma: a Korean multicenter database study

Authors
 Seung Hwan Song  ;  Jee Won Suh  ;  Woo Sik Yu  ;  Go Eun Byun  ;  Seong Yong Park  ;  Chang Young Lee  ;  Dae Joon Kim  ;  Hyo Chae Paik  ;  Kyung Young Chung  ;  Geun Dong Lee  ;  Sehoon Choi  ;  Hyeong Ryul Kim  ;  Yong-Hee Kim  ;  Dong Kwan Kim  ;  Seung-Il Park  ;  Jong Ho Cho  ;  Hong Kwan Kim  ;  Yong Soo Choi  ;  Jhingook Kim  ;  Jae Il Zo  ;  Young Mog Shim  ;  Yoohwa Hwang  ;  Samina Park  ;  In Kyu Park  ;  Chang Hyun Kang  ;  Young Tae Kim  ;  Jin Gu Lee 
Citation
 JOURNAL OF THORACIC DISEASE, Vol.12(11) : 6680-6689, 2020-11 
Journal Title
JOURNAL OF THORACIC DISEASE
ISSN
 2072-1439 
Issue Date
2020-11
Keywords
Thymoma ; postoperative radiotherapy (PORT) ; stage II ; stage III
Abstract
Background: Complete resection is a standard treatment for patients with Masaoka-Koga stages II and III thymoma, however the role of postoperative radiotherapy (PORT) is controversial. We analyzed data collected from 4 Korean hospitals to determine the effectiveness of PORT in stage II and III thymoma patients.

Methods: Between January 2000 and December 2013, 1,663 patients underwent surgery for thymic tumors at the 4 hospitals. Among them, 668 patients (527 with stage II and 141 with stage III) were investigated, among whom, 443 received PORT (335 with stage II and 108 with stage III). Propensity score matching (PSM) was performed, and 404 patients (346 with stage II and 58 with stage III) were selected.

Results: Perioperative characteristics were similar in the PORT and non-PORT groups after PSM. On survival analysis of stage II patients, the PORT and non-PORT groups showed no difference in either 5-year recurrence-free survival (RFS) (96.3% vs. 96.6%, P=0.622) or 5-year overall survival (OS) (94.6% vs. 93.8%, P=0.839). However, among stage III patients, the PORT group showed significantly better 5-year RFS (75.7% vs. 50.1%, P=0.040) and 5-year OS (86.5% vs. 54.7%, P=0.001). On multivariate Cox regression analysis, PORT was a significant positive prognostic factor in terms of both RFS (P=0.005) and OS (P=0.004) in patients with stage III thymomas, but not in those with stage II disease (P=0.987 and 0.968, respectively).

Conclusions: PORT improved the RFS and OS in stage III thymoma patients, but showed no survival benefit in stage II patients.
Files in This Item:
T202005395.pdf Download
DOI
10.21037/jtd-20-1713
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Park, Seong Yong(박성용) ORCID logo https://orcid.org/0000-0002-5180-3853
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Suh, Jee Won(서지원) ORCID logo https://orcid.org/0000-0003-0287-0651
Song, Seung Hwan(송승환)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Chung, Kyung Young(정경영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181319
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