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Ann Thorac Surg 2009;87:1641-1647. doi:10.1016/j.athoracsur.2008.11.022
© 2009 The Society of Thoracic Surgeons
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Adjuvant Radiotherapy for Thymic Epithelial Tumors: A Systematic Review and Meta-Analysis

Robert J. Korst, MDa,b,*, Amanda L. Kansler, MPHa, Paul J. Christos, MPH, MSc, Sanjay Mandal, MDa

a Daniel and Gloria Blumenthal Cancer Center, Paramus, New Jersey
b Division of Thoracic Surgery, Department of Surgery, Valley Hospital/Valley Health System, Ridgewood, New Jersey
c Division of Biostatistics and Epidemiology, Department of Public Health, Weill Medical College of Cornell University, New York, New York

* Address correspondence to Dr Korst, Daniel and Gloria Blumenthal Cancer Center, Thoracic Surgery, Valley Hospital/Valley Health System, 1 Valley Health Plaza, Paramus, NJ 07652 (Email: korsro{at}valleyhealth.com).

Adjuvant radiotherapy after complete resection of localized, invasive thymic epithelial tumors is considered by many to be the standard of care, despite little supporting literature. We hypothesized that individual studies may lack statistical power to demonstrate a reduction in recurrence with this approach, but meta-analysis of published data may allow for more adequate statistical evaluation. Analysis of data from 592 patients with completely resected stage II or III thymic epithelial tumors, however, revealed no statistically significant reduction in recurrence after adjuvant radiotherapy (odds ratio 1.05; 95% confidence interval: 0.63 to 1.75; p = 0.840). Additionally, the majority of publications suggest that the most common sites of recurrence are the lung, pleura, and diaphragm, even when incompletely resected patients are included.






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