Prognostic Factors of Recurrent Thymoma. Ten-year Experience and Results of Two Tertiary Centers in Greece

Dimitrios A. Lioumpas ¹, Ilias Samiotis ², Kalliopi Athanassiadi ², Charalampos Zisis ², Kostantinos Bouboulis ³, Ioannis Stamatatos ¹, Athanasios Stathoulopoulos ¹, Stylianos Zaragkas ¹, Despina Mylonaki ¹, Nikolaos Tzatzadakis ¹

¹ NIKAIA GENERAL HOSPITAL, ATHENS, Greece; ² EVAGGELISMOS GENERAL HOSPITAL, ATHENS, Greece; ³ Nikaia General Hospital, Athens, Greece, ATHENS, Greece;

Date, time and location: 2018.05.25 15:30, Congress Hall, 2F–C

Abstract

BACKROUND:Radical resection of thymomas is the most important predictor of survival. Despite macroscopically complete  resection, 10–30% of patients will develop recurrence. The study sought to analyze the prognostic factors of recurrent thymoma.

METHODS: We retrospectively reviewed the medical records of two tertiary thoracic surgery centers between 2005-2015, on 29 patients who experienced recurrent thymoma after surgical resection via median sternotomy. Masaoka stage IV and    type C thymic tumours were excluded from the study. 

RESULTS: The median follow-up duration after initial treatment was 62 months while the median recurrence free interval (RFI) was 33 months. The relapse rate was 18% (n=29) on the studied population, while the majority of patients (75%)   were alive without recurrence. Among the 29 relapsed patients, 11 underwent reoperation, 4 refused to undergo any      treatment and 2 died from non-tumor related cause. Age >59, the WHO histological mixed aplastic AB type and the early  recurrence (RFI <11 months) were found to be positive prognostic factors of reccurent thymoma. The relapse rates based on Masaoka staging were 0% for stage I, 8.7% and 35.7% for stages II and III respectively.

CONCLUSIONS: Masaoka stage I-II, RFI> 21 months, age < 59 and  radical macroscopically surgical resection (R0) were    found to be associated with good prognosis. Although many papers in literature highlight the potential correlation     between WHO updating histology and thymoma recurrence, our study showed that only the mixed AB aplastic subtype may be a predictor of tumor relapsing.