The role of adjuvant radiation therapy for resected stage III thymoma

A population-based study

Benny Weksler, Manisha Shende, Katie S. Nason, Angela Gallagher, Peter F. Ferson, Arjun Pennathur

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background: Because of the rarity of the disease and long survival of most patients, the role of adjuvant radiation therapy in patients with surgically resected stage III thymoma is unclear, and few prospective studies are available. The objective was to evaluate the impact of postoperative radiation therapy after resection of stage III thymoma. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was queried for all patients with stage III thymoma who underwent surgical therapy and survived more than 30 days after diagnosis. Survival was estimated with the Kaplan-Meier method. The hazard ratio for death was determined using a Cox proportional hazard model. Results: There were 476 patients with stage III thymoma identified who underwent surgical therapy, did not receive preoperative radiotherapy, and had complete SEER records with regard to radiation treatment. Postoperative radiation therapy was given to 322 patients (67.6%). Patients who received postoperative radiation therapy were younger and had a higher rate of debulking surgery than patients who did not. Patients receiving postoperative radiation had a median overall survival of 127 months (95% confidence interval, 100.9 to 153.1) compared with 105 months (95% confidence interval, 76.9 to 133.1) in patients treated with surgery alone (p = 0.038). However, in multivariate analysis, postoperative radiation was not a significant factor affecting overall survival. Disease-specific survival was significantly improved in the adjuvant radiation group, and in multivariate analysis, improved outcomes were associated with postoperative radiation (p = 0.049). Conclusions: In this large population-based study, most patients with stage III thymoma were treated with adjuvant radiation. Postoperative radiation was associated with improved disease-specific survival, but not improved overall survival.

Original languageEnglish (US)
Pages (from-to)1822-1829
Number of pages8
JournalAnnals of Thoracic Surgery
Volume93
Issue number6
DOIs
StatePublished - Jun 1 2012
Externally publishedYes

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Thymoma
Radiotherapy
Radiation
Population
Survival
Epidemiology
Multivariate Analysis
Confidence Intervals
Proportional Hazards Models
Therapeutics
Databases
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Surgery
  • Medicine(all)
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

The role of adjuvant radiation therapy for resected stage III thymoma : A population-based study. / Weksler, Benny; Shende, Manisha; Nason, Katie S.; Gallagher, Angela; Ferson, Peter F.; Pennathur, Arjun.

In: Annals of Thoracic Surgery, Vol. 93, No. 6, 01.06.2012, p. 1822-1829.

Research output: Contribution to journalArticle

Weksler, Benny ; Shende, Manisha ; Nason, Katie S. ; Gallagher, Angela ; Ferson, Peter F. ; Pennathur, Arjun. / The role of adjuvant radiation therapy for resected stage III thymoma : A population-based study. In: Annals of Thoracic Surgery. 2012 ; Vol. 93, No. 6. pp. 1822-1829.
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abstract = "Background: Because of the rarity of the disease and long survival of most patients, the role of adjuvant radiation therapy in patients with surgically resected stage III thymoma is unclear, and few prospective studies are available. The objective was to evaluate the impact of postoperative radiation therapy after resection of stage III thymoma. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was queried for all patients with stage III thymoma who underwent surgical therapy and survived more than 30 days after diagnosis. Survival was estimated with the Kaplan-Meier method. The hazard ratio for death was determined using a Cox proportional hazard model. Results: There were 476 patients with stage III thymoma identified who underwent surgical therapy, did not receive preoperative radiotherapy, and had complete SEER records with regard to radiation treatment. Postoperative radiation therapy was given to 322 patients (67.6{\%}). Patients who received postoperative radiation therapy were younger and had a higher rate of debulking surgery than patients who did not. Patients receiving postoperative radiation had a median overall survival of 127 months (95{\%} confidence interval, 100.9 to 153.1) compared with 105 months (95{\%} confidence interval, 76.9 to 133.1) in patients treated with surgery alone (p = 0.038). However, in multivariate analysis, postoperative radiation was not a significant factor affecting overall survival. Disease-specific survival was significantly improved in the adjuvant radiation group, and in multivariate analysis, improved outcomes were associated with postoperative radiation (p = 0.049). Conclusions: In this large population-based study, most patients with stage III thymoma were treated with adjuvant radiation. Postoperative radiation was associated with improved disease-specific survival, but not improved overall survival.",
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