Table 2. Recent studies on oncological outcomes of stage III and IV thymomas.
| Study name | Study period | Number of patients | Patients included | OS | PFS | DFS |
|---|---|---|---|---|---|---|
| Fan et al. 2020 (17) | 2000–2017 | 82 | Unresectable stage III thymomas | 5-year OS rates 65.7% vs. 26.8%; 10-year OS 55.8% vs. 13.4% (P=0.008). Patients in dRT vs. no-dRT group | 5- and 10-year PFS rate 46.1% and 34.6% in dRT vs. non-dRT, 17.0% and 0% (P=0.003) | NR |
| Lim et al. 2016 (34) | NR | 1,724 | Resected stage II to IV thymomas treated or not with PORT | Improvement of OS rate after PORT in stage III and IV thymomas (HR =0.63; 95% CI: 0.40–0.99). No improvement in OS rate with PORT in stage II thymomas (HR =1.45; 95% CI: 0.83–2.55) | NR | NR |
| Zhou et al. 2016 (35) | 1996–2015 | 3,823 | Resected stage II and stage III thymomas (2,096 received PORT and 1,727 received no PORT) | Increased duration of OS rates in stage II (HR =0.57; 95% CI: 0.41–0.80; P=0.001) and stage III thymomas (HR =0.73; 95% CI: 0.59–0.90; P=0.004) | NR | No impact of PORT on DFS rate vs. surgery alone (HR =1.21; 95% CI: 0.97–1.51; P=0.09) |
| Tian et al. 2020 (36) | 2011–2018 | 215 | Resected stage III and stage IV thymomas, associated (n=133) or not (n=82) to MG | 5-year OS 88.6% with no differences between MG and no-MG group | NR | NR |
| Maurizi et al. 2019 (21) | 1989–2015 | 27 | Resected thymomas and TCs, with SVC prosthetic replacement | 3- and 5-year OS rates 80% and 58.1%. Survival rates at 3 and 5 years 100% and 93.8% in thymoma patients vs. 50% and 0% in TC patients (P<0.008) | NR | 3- and 5-year DFS 90.5% and 67.0% |
| Aprile et al. 2019 (37) | 1990–2015 | 140 | Nerve-sparing surgery stage III and stage IV thymomas | 5-year OS rate 88% vs. 78% with no statistically differences between stages (P=0.33) | NR | DFS interval 287.6 vs. 28 months (P<0.001) in patients with stage III and stage thymomas respectively |
OS, overall survival; PFS, progression-free survival; DFS, disease-free survival; dRT, definitive radiotherapy; PORT, post-operative radiotherapy; HR, hazard ration; NR, not reported; MG, myasthenia gravis; TC, thymic carcinoma; SVC, superior vena cava.