Postoperative Radiotherapy After Surgical Resection of Thymoma: Differing Roles in Localized and Regional Disease

Forquer, Jeffrey A; Nan, Rong; Fakiris, Achilles J; Loehrer, Patrick J; Johnstone, Peter

doi:10.1016/j.ijrobp.2009.02.016

Title: Postoperative Radiotherapy After Surgical Resection of Thymoma: Differing Roles in Localized and Regional Disease

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Abstract

Purpose: To analyze the Surveillance, Epidemiology and End Results (SEER) registry data to determine the impact of postoperative radiotherapy (PORT) for thymoma and thymic carcinoma (T/TC). Methods and Materials: Patients with surgically resected localized (LOC) or regional (REG) malignant T/TC with or without PORT were analyzed for overall survival (OS) and cause-specific survival (CSS) by querying the SEER database from 1973-2005. Patients dying within the first 3 months after surgery were excluded. Kaplan-Meier and multivariate analyses with Cox proportional hazards were performed. Results: A total of 901 T/TC patients were identified (275 with LOC disease and 626 with REG disease). For all patients with LOC disease, PORT had no benefit and may adversely impact the 5-year CSS rate (91% vs. 98%, p = 0.03). For patients with REG disease, the 5-year OS rate was significantly improved by adding PORT (76% vs. 66% for surgery alone, p = 0.01), but the 5-year CSS rate was no better (91% vs. 86%, p = 0.12). No benefit was noted for PORT in REG disease after extirpative surgery (defined as radical or total thymectomy). On multivariate OS and CSS analysis, stage and age were independently correlated with survival. For multivariate CSS analysis, the outcomemore »« less

Authors:

Forquer, Jeffrey A ^[1]; Nan, Rong ^[2]; Fakiris, Achilles J ^[1]; Loehrer, Patrick J ^[3]; Johnstone, Peter ^[1]

Department of Radiation Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN (United States)
Department of Public Health, Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN (United States)
Department of Hematology Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN (United States)

Publication Date:: Mon Feb 01 00:00:00 EST 2010

OSTI Identifier:: 21372058

Resource Type:: Journal Article

Journal Name:: International Journal of Radiation Oncology, Biology and Physics

Additional Journal Information:: Journal Volume: 76; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2009.02.016; PII: S0360-3016(09)00246-6; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; MULTIVARIATE ANALYSIS; RADIOTHERAPY; THYMECTOMY; THYMUS; BODY; DISEASES; LYMPHATIC SYSTEM; MATHEMATICS; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; STATISTICS; SURGERY; THERAPY

Citation Formats


                    Forquer, Jeffrey A, Nan, Rong, Fakiris, Achilles J, Loehrer, Patrick J, and Johnstone, Peter. Postoperative Radiotherapy After Surgical Resection of Thymoma: Differing Roles in Localized and Regional Disease.  United States: N. p., 2010. 
        Web.  doi:10.1016/j.ijrobp.2009.02.016.

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                    Forquer, Jeffrey A, Nan, Rong, Fakiris, Achilles J, Loehrer, Patrick J, & Johnstone, Peter. Postoperative Radiotherapy After Surgical Resection of Thymoma: Differing Roles in Localized and Regional Disease.  United States.  https://doi.org/10.1016/j.ijrobp.2009.02.016

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                    Forquer, Jeffrey A, Nan, Rong, Fakiris, Achilles J, Loehrer, Patrick J, and Johnstone, Peter. 2010.  
        "Postoperative Radiotherapy After Surgical Resection of Thymoma: Differing Roles in Localized and Regional Disease".  United States.  https://doi.org/10.1016/j.ijrobp.2009.02.016.

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@article{osti_21372058,

  title        = {Postoperative Radiotherapy After Surgical Resection of Thymoma: Differing Roles in Localized and Regional Disease},

  author       = {Forquer, Jeffrey A and Nan, Rong and Fakiris, Achilles J and Loehrer, Patrick J and Johnstone, Peter},

  abstractNote = {Purpose: To analyze the Surveillance, Epidemiology and End Results (SEER) registry data to determine the impact of postoperative radiotherapy (PORT) for thymoma and thymic carcinoma (T/TC). Methods and Materials: Patients with surgically resected localized (LOC) or regional (REG) malignant T/TC with or without PORT were analyzed for overall survival (OS) and cause-specific survival (CSS) by querying the SEER database from 1973-2005. Patients dying within the first 3 months after surgery were excluded. Kaplan-Meier and multivariate analyses with Cox proportional hazards were performed. Results: A total of 901 T/TC patients were identified (275 with LOC disease and 626 with REG disease). For all patients with LOC disease, PORT had no benefit and may adversely impact the 5-year CSS rate (91% vs. 98%, p = 0.03). For patients with REG disease, the 5-year OS rate was significantly improved by adding PORT (76% vs. 66% for surgery alone, p = 0.01), but the 5-year CSS rate was no better (91% vs. 86%, p = 0.12). No benefit was noted for PORT in REG disease after extirpative surgery (defined as radical or total thymectomy). On multivariate OS and CSS analysis, stage and age were independently correlated with survival. For multivariate CSS analysis, the outcome of PORT is significantly better for REG disease than for LOC disease (hazard ratio, 0.167; p = 0.001). Conclusions: Our results from SEER show that PORT for T/TC had no advantage in patients with LOC disease (Masaoka Stage I), but a possible OS benefit of PORT in patients with REG disease (Masaoka Stage II-III) was found, especially after non-extirpative surgery. The role of PORT in T/TC needs further evaluation.},

  doi          = {10.1016/j.ijrobp.2009.02.016},

  url          = {https://www.osti.gov/biblio/21372058},
  journal      = {International Journal of Radiation Oncology, Biology and Physics},

  issn         = {0360-3016},

  number       = 2,

  volume       = 76,

  place        = {United States},

  year         = {Mon Feb 01 00:00:00 EST 2010},

  month        = {Mon Feb 01 00:00:00 EST 2010}

}

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