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. 1996 Aug;224(2):219–224. doi: 10.1097/00000658-199608000-00016

Is postoperative radiotherapy for thymoma effective?

M Haniuda 1, M Miyazawa 1, K Yoshida 1, M Oguchi 1, F Sakai 1, I Izuno 1, S Sone 1
PMCID: PMC1235345  PMID: 8757387

Abstract

OBJECTIVE: The authors determined the effect of postoperative mediastinal irradiation in preventing local and pleural recurrence of thymoma. SUMMARY BACKGROUND DATA: The role of mediastinal irradiation after incomplete resection or biopsy of an invasive thymoma is well established. However, routine use of adjuvant mediastinal irradiation for patients with thymoma after complete resection remains controversial. METHODS: During the 19-year period from 1973 to 1992, operations were performed on 89 patients with thymoma. Of these 89 patients, 80 patients who underwent gross complete tumor resection including adjacent tissues that appeared to be invaded by tumor were selected for this study. The effects of postoperative mediastinal irradiation on the recurrence rate of thymoma were analyzed according to histologic type, clinical stage, and whether adhesions to or invasion of the pleura or pericardium were present. RESULTS: Recurrence of thymoma was observed in 13 of 80 (16.3%) patients. No recurrence was observed in 23 patients with noninvasive thymoma. In patients with invasive thymoma whose tumor was macroscopically adherent to the pleura but not microscopically invasive (p1), recurrence was observed in 4 of 11 patients (36.4%) when mediastinal irradiation was not performed, but in none of 10 patients who received mediastinal irradiation. However, in patients with microscopic pleural invasion (p2), a high recurrence rate was observed with mediastinal irradiation (40%, 6/15 patients) or without mediastinal irradiation (30%, 3/10 patients). Postoperative mediastinal irradiation for patients with microscopical invasion to pericardium (c2) did not decrease the recurrence rate. Analysis of the mode of recurrence showed that mediastinal irradiation may have been effective in preventing local recurrence, but it did not control the pleural dissemination that was observed in 12 of 13 recurrent cases. CONCLUSIONS: Mediastinal irradiation is not necessary for patients with noninvasive thymoma. In patients with invasive thymoma, postoperative mediastinal irradiation is effective in preventing recurrence in patients with p1 thymoma, but not in patients with p2 or c2 tumors. Further adjuvant therapy should be performed to supplement mediastinal irradiation in patients with p2 or c2 thymoma, even after complete resection.

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Selected References

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  1. Batata M. A., Martini N., Huvos A. G., Aguilar R. I., Beattie E. J., Jr Thymomas: clinicopathologic features, therapy, and prognosis. Cancer. 1974 Aug;34(2):389–396. doi: 10.1002/1097-0142(197408)34:2<389::aid-cncr2820340224>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  2. Bernatz P. E., Khonsari S., Harrison E. G., Jr, Taylor W. F. Thymoma: factors influencing prognosis. Surg Clin North Am. 1973 Aug;53(4):885–892. doi: 10.1016/s0039-6109(16)40093-9. [DOI] [PubMed] [Google Scholar]
  3. Cohen D. J., Ronnigen L. D., Graeber G. M., Deshong J. L., Jaffin J., Burge J. R., Zajtchuk R. Management of patients with malignant thymoma. J Thorac Cardiovasc Surg. 1984 Feb;87(2):301–307. [PubMed] [Google Scholar]
  4. Curran W. J., Jr, Kornstein M. J., Brooks J. J., Turrisi A. T., 3rd Invasive thymoma: the role of mediastinal irradiation following complete or incomplete surgical resection. J Clin Oncol. 1988 Nov;6(11):1722–1727. doi: 10.1200/JCO.1988.6.11.1722. [DOI] [PubMed] [Google Scholar]
  5. Fujimura S., Kondo T., Handa M., Shiraishi Y., Tamahashi N., Nakada T. Results of surgical treatment for thymoma based on 66 patients. J Thorac Cardiovasc Surg. 1987 May;93(5):708–714. [PubMed] [Google Scholar]
  6. Haniuda M., Morimoto M., Nishimura H., Kobayashi O., Yamanda T., Iida F. Adjuvant radiotherapy after complete resection of thymoma. Ann Thorac Surg. 1992 Aug;54(2):311–315. doi: 10.1016/0003-4975(92)91391-l. [DOI] [PubMed] [Google Scholar]
  7. Jackson M. A., Ball D. L. Post-operative radiotherapy in invasive thymoma. Radiother Oncol. 1991 Jun;21(2):77–82. doi: 10.1016/0167-8140(91)90078-u. [DOI] [PubMed] [Google Scholar]
  8. Krueger J. B., Sagerman R. H., King G. A. Stage III thymoma: results of postoperative radiation therapy. Radiology. 1988 Sep;168(3):855–858. doi: 10.1148/radiology.168.3.3136511. [DOI] [PubMed] [Google Scholar]
  9. Lewis J. E., Wick M. R., Scheithauer B. W., Bernatz P. E., Taylor W. F. Thymoma. A clinicopathologic review. Cancer. 1987 Dec 1;60(11):2727–2743. doi: 10.1002/1097-0142(19871201)60:11<2727::aid-cncr2820601125>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  10. Maggi G., Casadio C., Cavallo A., Cianci R., Molinatti M., Ruffini E. Thymoma: results of 241 operated cases. Ann Thorac Surg. 1991 Jan;51(1):152–156. doi: 10.1016/0003-4975(91)90478-9. [DOI] [PubMed] [Google Scholar]
  11. Maggi G., Giaccone G., Donadio M., Ciuffreda L., Dalesio O., Leria G., Trifiletti G., Casadio C., Palestro G., Mancuso M. Thymomas. A review of 169 cases, with particular reference to results of surgical treatment. Cancer. 1986 Aug 1;58(3):765–776. doi: 10.1002/1097-0142(19860801)58:3<765::aid-cncr2820580326>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
  12. Marks R. D., Jr, Wallace K. M., Pettit H. S. Radition therpay control of nine patients with malignant thymoma. Cancer. 1978 Jan;41(1):117–119. doi: 10.1002/1097-0142(197801)41:1<117::aid-cncr2820410118>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  13. Masaoka A., Monden Y., Nakahara K., Tanioka T. Follow-up study of thymomas with special reference to their clinical stages. Cancer. 1981 Dec 1;48(11):2485–2492. doi: 10.1002/1097-0142(19811201)48:11<2485::aid-cncr2820481123>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  14. Monden Y., Nakahara K., Iioka S., Nanjo S., Ohno K., Fujii Y., Hashimoto J., Kitagawa Y., Masaoka A., Kawashima Y. Recurrence of thymoma: clinicopathological features, therapy, and prognosis. Ann Thorac Surg. 1985 Feb;39(2):165–169. doi: 10.1016/s0003-4975(10)62558-1. [DOI] [PubMed] [Google Scholar]
  15. Nakahara K., Ohno K., Hashimoto J., Maeda H., Miyoshi S., Sakurai M., Monden Y., Kawashima Y. Thymoma: results with complete resection and adjuvant postoperative irradiation in 141 consecutive patients. J Thorac Cardiovasc Surg. 1988 Jun;95(6):1041–1047. [PubMed] [Google Scholar]
  16. Uematsu M., Kondo M. A proposal for treatment of invasive thymoma. Cancer. 1986 Nov 1;58(9):1979–1984. doi: 10.1002/1097-0142(19861101)58:9<1979::aid-cncr2820580904>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
  17. Urgesi A., Monetti U., Rossi G., Ricardi U., Casadio C. Role of radiation therapy in locally advanced thymoma. Radiother Oncol. 1990 Nov;19(3):273–280. doi: 10.1016/0167-8140(90)90154-o. [DOI] [PubMed] [Google Scholar]
  18. Verley J. M., Hollmann K. H. Thymoma. A comparative study of clinical stages, histologic features, and survival in 200 cases. Cancer. 1985 Mar 1;55(5):1074–1086. doi: 10.1002/1097-0142(19850301)55:5<1074::aid-cncr2820550524>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  19. Wang L. S., Huang M. H., Lin T. S., Huang B. S., Chien K. Y. Malignant thymoma. Cancer. 1992 Jul 15;70(2):443–450. doi: 10.1002/1097-0142(19920715)70:2<443::aid-cncr2820700212>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  20. Wilkins E. W., Jr, Castleman B. Thymoma: a continuing survey at the Massachusetts General Hospital. Ann Thorac Surg. 1979 Sep;28(3):252–256. doi: 10.1016/s0003-4975(10)63114-1. [DOI] [PubMed] [Google Scholar]

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