Tumor size as a prognostic factor in limited-stage thymic epithelial tumors: A multicenter analysis

Korean Association for Research on the Thymus (KART)

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12 Scopus citations

Abstract

Objective: The prognostic significance of tumor size in thymic epithelial tumors (TETs) has not been fully evaluated. We aimed to clarify the prognostic value of tumor size in limited-stage and advanced-stage TETs. Methods: Clinical records of patients with completely resected TETs were retrospectively collected from 4 tertiary centers between January 2000 and February 2013. Information on the Masaoka–Koga stage was available for 1215 patients (M-K group), and 433 patients were classified according to the eighth edition of the Tumor-Node-Metastasis staging system (TNM group). Limited-stage and advanced-stage TETs were defined according to whether they were confined within the surrounding fatty tissues without invasion. The optimal cutoff value was selected using a maximally selected log-rank statistic. Results: The median tumor size was 6.0 ± 2.8 cm in the M-K group and 6.5 ± 3.0 cm in the TNM group. In the multivariable analysis, tumor size had a significant effect on both overall survival (P =.003) and recurrence-free survival (P <.001) for limited-stage tumors (M-K stage I or II or TNM stage I), but not for advanced-stage tumors (M-K stage III or IV or TNM stage II-IV; P =.349 for overall survival and P =.439 for recurrence-free survival). The optimal cutoff value for tumor size was >5.5 cm for both overall survival and recurrence-free survival in limited-stage TETs. Conclusions: Tumor size is an independent prognostic factor in patients with completely resected limited-stage TETs and a cutoff value >5.5 cm might help clinicians enact proper treatment strategies and surveillance.

Original languageEnglish
Pages (from-to)309-317.e9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume162
Issue number1
DOIs
StatePublished - Jul 2021

Bibliographical note

Funding Information:
Members of the KART Study Group: Geun Dong Lee, Su Kyung Hwang, Sehoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea); Sumin Shin, Jong Ho Cho, Hong Kwan Kim, Jhingook Kim, Jae Il Zo, Young Mog Shim (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea); Samina Park, Kwan Yong Hyun, Yoohwa Hwang, Hyun Joo Lee, In Kyu Park, Chang Hyun Kang, Young Tae Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea); and Chang Young Lee, Jin Gu Lee, Hyo Chae Paik, Dae Joon Kim, Kyung Young Chung (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea).

Publisher Copyright:
© 2020 The American Association for Thoracic Surgery

Keywords

  • recurrence
  • risk factors
  • survival
  • thymic malignancy
  • tumor size

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