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Evaluation of the new TNM-staging system for thymic malignancies: impact on indication and survival.
- Source :
-
World journal of surgical oncology [World J Surg Oncol] 2017 Dec 02; Vol. 15 (1), pp. 214. Date of Electronic Publication: 2017 Dec 02. - Publication Year :
- 2017
-
Abstract
- Background: The objective of this study is the evaluation of the Masaoka-Koga and the International Association for the Study of Lung Cancer (IASLC)/International Thymic Malignancy Interest Group (ITMIG) proposal for the new TNM-staging system on clinical implementation and prognosis of thymic malignancies.<br />Methods: A retrospective study of 76 patients who underwent surgery between January 2005 and December 2015 for thymoma. Kaplan-Meier survival analysis was used to determine overall and recurrence-free survival rates.<br />Results: Indication for surgery was primary mediastinal tumor (n = 55), pleural manifestation (n = 17), or mediastinal recurrence (n = 4) after surgery for thymoma. Early Masaoka-Koga stages I (n = 9) and II (n = 14) shifted to the new stage I (n = 23). Advanced stages III (Masaoka-Koga: n = 20; ITMIG/IASLC: n = 17) and IV (Masaoka-Koga: n = 33; ITMIG/IASLC: n = 35) remained nearly similar and were associated with higher levels of WHO stages. Within each staging system, the survival curves differed significantly with the best 5-year survival in early stages I and II (91%). Survival for stage IV (70 to 77%) was significantly better compared to stage III (49 to 54%). Early stages had a significant longer recurrence-free survival (86 to 90%) than advanced stages III and IV (55 to 56%).<br />Conclusions: The proportion of patients with IASLC/ITMIG stage I increased remarkably, whereas the distribution in advanced stages III and IV was nearly similar. The new TNM-staging system presents a clinically useful and applicable system, which can be used for indication, stage-adapted therapy, and prediction of prognosis for overall and recurrence-free survival.
- Subjects :
- Adult
Aged
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Male
Mediastinal Neoplasms epidemiology
Mediastinal Neoplasms secondary
Mediastinal Neoplasms surgery
Mediastinum pathology
Mediastinum surgery
Middle Aged
Neoplasm Recurrence, Local epidemiology
Neoplasm Recurrence, Local pathology
Neoplasm Staging
Pleural Neoplasms secondary
Pleural Neoplasms surgery
Prognosis
Retrospective Studies
Thymoma mortality
Thymoma secondary
Thymoma surgery
Thymus Neoplasms classification
Thymus Neoplasms mortality
Thymus Neoplasms surgery
Mediastinal Neoplasms pathology
Neoplasm Recurrence, Local surgery
Pleural Neoplasms pathology
Thymoma pathology
Thymus Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1477-7819
- Volume :
- 15
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- World journal of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 29197400
- Full Text :
- https://doi.org/10.1186/s12957-017-1283-4