HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Stefano Margaritora Alfredo Cesario Giacomo Cusumano Pierluigi Granone Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Margaritora, S. Articles by Granone, P. Search for Related Content PubMed PubMed Citation Articles by Margaritora, S. Articles by Granone, P. Related Collections Mediastinum

---

Original Articles: General Thoracic

Thirty-Five–Year Follow-Up Analysis of Clinical and Pathologic Outcomes of Thymoma Surgery

^a Division of General Thoracic Surgery, Catholic University, Rome, Italy
^e Institute of Histopathology, Catholic University, Rome, Italy
^f Institute of Neurology, Catholic University, Rome, Italy
^b CDC, San Raffaele Velletri, Rome, Italy
^c Department of Radiotherapy, Campus Biomedico University, Rome, Italy
^d Unit of Molecular and Clinical Epidemiology, IRCCS San Raffaele, Rome, Italy

Accepted for publication August 31, 2009.

^_* Address correspondence to Dr Cusumano, Catholic University, Policlinico Gemelli Rome, Largo F. Vito 1, Rome, 000168, Italy (Email: giacomare55{at}hotmail.com).

Presented at the Forty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Francisco, CA, Jan 26–28, 2009.

Background: The impact of myasthenia gravis on patients with thymoma is still controversial when perioperative and long-term outcomes are analyzed. With the unique opportunity of a 35-year follow-up in a single institution, thymomatous myasthenia gravis cohort, we investigated the influence of early and long-term clinical predictors.

Methods: We reviewed a surgical series of 317 (1972 to 2007) patients with thymoma: clinical and pathologic features were analyzed as prognostic factors matched against the short- and long-term survival and recurrence rates.

Results: Male to female ratio was 153:164; median age, 49 years. Myasthenia gravis coexisted in 276 patients (87.1%). Thymomas were classified according to the Masaoka (42.0% stage I, 32.2% stage II, 21.5% stage III, and 4.4% stage IV) and the World Health Organization (3.5% type A, 9.5% type AB, 19.2% type B1, 57.7% type B2, 8.2% type B3, and 1.9% thymic carcinoma) staging systems. The resection was complete in 295 patients (93.1%). Operative mortality and morbidity were respectively 1.6% and 7.6%. No differences were recorded in postoperative outcome stratifying for myasthenia gravis or comorbidities. Mean follow-up was 144.7 ± 104.4 months. The overall 5-, 10-, 20-, and 30-year survival rates were 89.9%, 84.1%, 73%, and 58.6%, respectively. The completeness of resection (p < 0.001), the Masaoka staging (p = 0.010), and the World Health Organization classification (p < 0.001) all significantly influenced the long-term survival (univariate analysis). Only completeness of resection was significantly correlated with a better prognosis (p < 0.001) in multivariate analysis. Masaoka staging (p < 0.001) and World Health Organization classification (p < 0.001) significantly correlated with the disease-free survival in the univariate and multivariate analyses as significant prognostic factors (Masaoka, p < 0.001; World Health Organization, p = 0.011). Myasthenia gravis patients showed a better prognosis in terms of long-term survival (p = 0.046) and disease-free survival (p = 0.012) in the univariate analysis.

Conclusions: We confirm the evidence that the clinical staging and the histologic classification influence long-term survival. The presence of myasthenia gravis was not significantly related to operative outcome, but prolongs both long-term survival and disease-free survival.

This article has been cited by other articles:

				R. J. Kelly, I. Petrini, A. Rajan, Y. Wang, and G. Giaccone Thymic Malignancies: From Clinical Management to Targeted Therapies J. Clin. Oncol., December 20, 2011; 29(36): 4820 - 4827. [Abstract] [Full Text] [PDF]

				M. Sakamoto, T. Murakawa, C. Konoeda, Y. Inoue, K. Kitano, A. Sano, M. Fukayama, and J. Nakajima Survival after extended thymectomy for thymoma Eur J Cardiothorac Surg, October 18, 2011; (2011) ezr026v1. [Abstract] [Full Text] [PDF]

				S. Margaritora, A. Cesario, G. Cusumano, F. Lococo, V. Porziella, E. Meacci, A. Evoli, and P. Granone Single-centre 40-year results of redo operation for recurrent thymomas Eur J Cardiothorac Surg, October 1, 2011; 40(4): 894 - 901. [Abstract] [Full Text] [PDF]

				J. Li Myasthenia Gravis and Recurrent Thymoma Ann. Thorac. Surg., July 1, 2011; 92(1): 406 - 406. [Full Text] [PDF]

				S. Margaritora, G. Cusumano, F. Lococo, and P. Granone Reply Ann. Thorac. Surg., July 1, 2011; 92(1): 406 - 407. [Full Text] [PDF]

				E. Ruffini, P. L. Filosso, C. Mossetti, M. C. Bruna, D. Novero, P. Lista, C. Casadio, and A. Oliaro Thymoma: inter-relationships among World Health Organization histology, Masaoka staging and myasthenia gravis and their independent prognostic significan a single-centre experience Eur J Cardiothorac Surg, July 1, 2011; 40(1): 146 - 153. [Abstract] [Full Text] [PDF]

				D. Fabre, E. Fadel, S. Mussot, O. Mercier, B. Petkova, B. Besse, J. Huang, and P. G. Dartevelle Long-term outcome of pleuropneumonectomy for Masaoka stage IVa thymoma Eur J Cardiothorac Surg, May 1, 2011; 39(5): e133 - e138. [Abstract] [Full Text] [PDF]

				M. R. Wick Histopathologic Prognosis of Thymomas: Another Example of Medical Surrogacy Am J Clin Pathol, November 1, 2010; 134(5): 703 - 705. [Full Text] [PDF]

				R. T. Cheney The Biologic Spectrum of Thymic Epithelial Neoplasms: Current Status and Future Prospects J Natl Compr Canc Netw, November 1, 2010; 8(11): 1322 - 1328. [Abstract] [Full Text] [PDF]