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. 2018 Feb 20;24(1):6-12.
doi: 10.5761/atcs.oa.17-00108. Epub 2017 Dec 8.

Role of Surgery in the Treatment of Masaoka Stage IVa Thymoma

Erkan Kaba  1 , Berker Ozkan  2 , Suat Erus  2 , Salih Duman  2 , Berk Cimenoglu  2 , Alper Toker  2   3
Affiliations

Role of Surgery in the Treatment of Masaoka Stage IVa Thymoma

Erkan Kaba et al. Ann Thorac Cardiovasc Surg. .

Abstract

Purpose: To analyze the role of surgery in patients with Masaoka stage IVa thymoma treated with multimodality therapy.

Methods: Of 191 patients undergoing surgery for thymoma in our department between January 2002 and December 2015, 39 (20.4%) had Masaoka stage IVa. Histopathological tumor type, myasthenic status of the Osserman-Genkins score, Masaoka stage at the first surgery, neoadjuvant treatment, number and type of surgeries, and survival rates were recorded.

Results: Thymoma B2 was the most common histopathological tumor type (n = 16, 41%). Twenty-six (66.7%) patients underwent primary surgeries for Masaoka stage IVa thymoma, whereas nine (23.1%) underwent secondary surgeries and four (10.3%) underwent tertiary surgeries for pleural or pericardial recurrences. Median survival was 132 ± 25 (82-181; 95% confidence interval [CI]) months. Overall 3-, 5-, and 10-year survival rates were 93%, 93%, and 56%, respectively.

Conclusion: Surgical treatment should be considered as a completion modality to oncological therapy and has the potential to provide long-term survival of Masaoka stage IVa in patients with thymoma. The type of surgery should be determined based on the invasiveness of the lesion.

Keywords: Masaoka stage IVa; surgery; thymoma.

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Figures

Fig. 1
Fig. 1. Survival graphic: surgery type. PP: pleuropneumonectomy; P/D: radical pleurectomy/decortication; LE: local excision of the pleural/pericardial/diaphragmatic implants
Fig. 2
Fig. 2. Survival graphic: stage at primary surgery.
See this image and copyright information in PMC

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