Pier Luigi Filosso1, Federico Venuta2, Alberto Oliaro3, Enrico Ruffini3, Erino Angelo Rendina4, Stefano Margaritora5, Caterina Casadio6, Alberto Terzi7, Ottavio Rena6, Filippo Lococo8, Francesco Guerrera3. 1. Department of Thoracic Surgery, University of Torino, Torino, Italy pierluigi.filosso@unito.it. 2. Department of Thoracic Surgery, Fondazione Eleonora Lorillard Spencer Cenci, Policlinico 'Umberto I', University of Rome Sapienza, Rome, Italy. 3. Department of Thoracic Surgery, University of Torino, Torino, Italy. 4. Department of Thoracic Surgery, Fondazione Eleonora Lorillard Spencer Cenci, 'S.Andrea Hospital', University of Rome Sapienza, Rome, Italy. 5. Unit of Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy. 6. Unit of Thoracic Surgery, 'Amedeo Avogadro' University, Novara, Italy. 7. Unit of Thoracic Surgery, 'Santa Croce e Carle Hospital', Cuneo, Italy. 8. Department of Thoracic Surgery, Azienda Ospedaliera Santa Maria Nuova, IRCCS Reggio Emilia, Emilia, Italy.
Abstract
OBJECTIVES: In thymomas, the roles of Masaoka-Koga stage, histology and the presence of myasthenia gravis (MG) have been considered fundamental for patient management and outcomes. In this study, we retrospectively evaluated several clinical variables, with the aim of outlining their relationships and clinical/prognostic significance in resected thymoma patients. METHODS: A retrospective search of our surgical database for patients operated on for thymoma in six Italian high-volume thoracic surgery centres between 2000 and 2011 was conducted. The following clinical variables were evaluated: Masaoka-Koga Stage, tumour histology, the presence of MG, other autoimmune syndromes or second tumours, the completeness of tumour resection and the development of recurrences. RESULTS: Five hundred and thirty-seven (273 males-51%) were retrospectively included in this study. Our results indicate that: (i) MG correlates with early Masaoka-Koga stage and B-type thymoma; (ii) Stage III-IVa tumours correlate with B-type tumour; (iii) autoimmune paraneoplastic syndromes correlate with Stage I-II thymoma; (iv) second malignancies correlate with the absence of paraneoplastic disorders and weakly with B-type tumour and (v) overall survival was influenced by Masaoka-Koga stage and completeness of surgical resection. CONCLUSIONS: In thymomas, Masaoka-Koga stage, histology, MG, other autoimmune syndromes and second malignancies are inter-related, but only Masaoka-Koga tumour stage, amid these clinical variables, has been demonstrated to be a strong prognostic indicator of survival.
OBJECTIVES: In thymomas, the roles of Masaoka-Koga stage, histology and the presence of myasthenia gravis (MG) have been considered fundamental for patient management and outcomes. In this study, we retrospectively evaluated several clinical variables, with the aim of outlining their relationships and clinical/prognostic significance in resected thymomapatients. METHODS: A retrospective search of our surgical database for patients operated on for thymoma in six Italian high-volume thoracic surgery centres between 2000 and 2011 was conducted. The following clinical variables were evaluated: Masaoka-Koga Stage, tumour histology, the presence of MG, other autoimmune syndromes or second tumours, the completeness of tumour resection and the development of recurrences. RESULTS: Five hundred and thirty-seven (273 males-51%) were retrospectively included in this study. Our results indicate that: (i) MG correlates with early Masaoka-Koga stage and B-type thymoma; (ii) Stage III-IVa tumours correlate with B-type tumour; (iii) autoimmune paraneoplastic syndromes correlate with Stage I-II thymoma; (iv) second malignancies correlate with the absence of paraneoplastic disorders and weakly with B-type tumour and (v) overall survival was influenced by Masaoka-Koga stage and completeness of surgical resection. CONCLUSIONS: In thymomas, Masaoka-Koga stage, histology, MG, other autoimmune syndromes and second malignancies are inter-related, but only Masaoka-Koga tumour stage, amid these clinical variables, has been demonstrated to be a strong prognostic indicator of survival.
Authors: Clara Salles Figueiredo; Isabela Bispo Santos da Silva Costa; Cristina Salvadori Bittar; Antonio Fernando Lins de Paiva; Ivanhoé Stuart Lima; Paulo Henrique do Amor Divino; Carolina Maria P D de C Silva; Silvia Moulin Ribeiro Fonseca; Roberto Kalil Filho; Ludhmila Abrahão Hajjar Journal: AME Case Rep Date: 2020-10-30