Treatment options for operable or potentially operable stages III and IV thymoma

Surgery followed by PORT.

Induction chemotherapy followed by surgery and radiation therapy.

Data were obtained from a large clinical study of 1,320 Japanese patients.[14] Patients with stage III and stage IV thymoma underwent surgery and multimodality therapy with surgical resection followed by adjuvant therapy consisting of radiation therapy and/or chemotherapy.

Data were obtained from a large clinical study of 1,320 Japanese patients.[14] Patients with stage III and stage IV thymoma underwent surgery and multimodality therapy with surgical resection followed by adjuvant therapy consisting of radiation therapy and/or chemotherapy.

The Masaoka clinical stage was found to correlate well with prognosis of thymoma and thymic carcinoma.

Data were obtained from a large clinical study of 1,320 Japanese patients.[14] Patients with stage III and stage IV thymoma underwent surgery and multimodality therapy with surgical resection followed by adjuvant therapy consisting of radiation therapy and/or chemotherapy.

For patients with stage III or stage IV thymoma, the 5-year survival rates were 93% for patients treated with total resection, 64% for patients treated with subtotal resection, and 36% for patients whose disease was inoperable. These data highlight the prognostic significance of achieving complete surgical resection of the tumor.

Data were obtained from a large clinical study of 1,320 Japanese patients.[14] Patients with stage III and stage IV thymoma underwent surgery and multimodality therapy with surgical resection followed by adjuvant therapy consisting of radiation therapy and/or chemotherapy.

Prophylactic mediastinal radiation therapy did not appear to prevent local recurrences effectively in patients with totally resected stage III thymoma.

Data were obtained from a large clinical study of 1,320 Japanese patients.[14] Patients with stage III and stage IV thymoma underwent surgery and multimodality therapy with surgical resection followed by adjuvant therapy consisting of radiation therapy and/or chemotherapy.

Adjuvant therapy, including radiation and/or chemotherapy did not appear to improve the prognosis in patients with totally resected stage III or stage IV thymoma.

In a large retrospective study, 1,334 patients diagnosed with malignant thymoma and treated between 1973 and 2005 were identified in a Surveillance, Epidemiology, and End Results (SEER) Program database.[25]

In a large retrospective study, 1,334 patients diagnosed with malignant thymoma and treated between 1973 and 2005 were identified in a Surveillance, Epidemiology, and End Results (SEER) Program database.[25]

At a relatively short median follow-up of 65 months, radiation therapy did not appear to increase the risk of cardiac mortality or secondary malignancy.

In a large retrospective study, 1,334 patients diagnosed with malignant thymoma and treated between 1973 and 2005 were identified in a Surveillance, Epidemiology, and End Results (SEER) Program database.[25]

In patients with stage III and stage IV disease (after excluding patients surviving less than 4 months to account for surgical mortality), the routine use of PORT did not appear to improve long-term survival.

In a retrospective study, 476 patients with stage III thymoma who underwent surgical resection were identified using the SEER database. PORT was administered to 322 patients (67.6%).[26]

In a retrospective study, 476 patients with stage III thymoma who underwent surgical resection were identified using the SEER database. PORT was administered to 322 patients (67.6%).[26]

Patients who received PORT had a median OS of 127 months (95% confidence interval [CI], 100.9–153.1) compared with 105 months (95% CI, 76.9–133.1) in patients treated with surgery alone (P = .038).

In a retrospective study, 476 patients with stage III thymoma who underwent surgical resection were identified using the SEER database. PORT was administered to 322 patients (67.6%).[26]

Disease-specific survival was significantly improved in patients receiving PORT compared with patients undergoing surgery alone (P = .049).

Different published series have reported long-term survival rates following induction chemotherapy and surgery, with or without radiation therapy and consolidation chemotherapy. The rates have ranged from 50% at 4 years to 77% at 7 years, with 10-year rates of 86% for stage III patients and 76% for stage IV patients.[5,22,23,27]

Similar survival rates have been reported with preoperative radiation therapy without chemotherapy, particularly if great vessels are involved. Results showed a 5-year OS rate of 77% and a 10-year OS rate of 59%.[28,29]