Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center

Yıl: 2021 Cilt: 29 Sayı: 4 Sayfa Aralığı: 487 - 495 Metin Dili: İngilizce DOI: 10.5606/tgkdc.dergisi.2021.20529 İndeks Tarihi: 12-05-2022

Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center

Öz:
Background: In this study, we aimed to evaluate the factors that contribute tosurvival outcomes in patients with thymoma treated with multimodal approaches. Methods: A total of 203 patients (105 males, 98 females; median age: 49 years;range, 17 to 77 years) with Masaoka-Koga Stage II-IV thymoma betweenJanuary 2002 and December 2018 were retrospectively analyzed. Data includingdiagnosis of myasthenia gravis, diagnosis of diabetes mellitus, disease stage,histological type of tumor, capsule invasion and surgical margin status,lymphadenectomy, adjuvant radiotherapy or chemotherapy, time from surgeryto the first day of adjuvant treatment, length of hospital stay, and overall anddisease-free survival rates were recorded. Results: Of the patients, 91 had Stage II, 67 had Stage III, and 45 had Stage IVdisease. A total of 123 patients (61%) had myasthenia gravis. Seventy-six patientsreceived adjuvant radiotherapy and 48 patients received either neoadjuvant(n=35) or adjuvant (n=25) chemotherapy. Higher disease stage, presence ofR1 resection, and treatment with chemotherapy were significant factors fordecreased disease-free survival time. Older age, higher disease stage, longerpostoperative hospital stay, chemotherapy, and disease recurrence were effectivecontributors to decreased overall survival time. Adjuvant radiotherapy had astatistically significant positive effect on overall survival only in patients withcompletely resected Stage IV disease (five-year overall survival: 94.7% vs. 79.1%,respectively; p=0.015). In the multivariate analysis, older age (hazard ratio: 4.26),higher disease stage (hazard ratio: 2.95), and longer hospitalization time (hazardratio: 3.81) were significant prognostic factors for overall survival. Patientswith local recurrence who underwent complete resection had a survival timecomparable to non-recurrent patients (p=0.753). Conclusion: For patients with thymoma, higher disease stage, age ≥50 years,longer hospitalization, and need for chemotherapy are associated with worsesurvival rates. Adjuvant chemotherapy has a positive impact on Stage IV disease.Resection of recurrent lesions has a valuable impact on survival.
Anahtar Kelime:

Multimodal tedavi sonrası timoma hastalığının seyri ve hastalarda sağkalımın belirleyicileri:Üçüncü basamak kanser merkezinin 16 yıllık deneyimi

Öz:
Amaç: Bu çalışmada, multimodal yaklaşımlar ile tedavi edilen timomahastalarının sağkalım sonuçlarına katkıda bulunan faktörler değerlendirildi. Ça­lış­ma pla­nı: Ocak 2002 - Aralık 2018 tarihleri arasında Masaoka-KogaEvre II-IV timomalı toplam 203 hasta (105 erkek, 98 kadın; medyan yaş: 49yıl; dağılım, 17-77 yıl) retrospektif olarak incelendi. Myastenia gravis tanısı,diabetes mellitus tanısı, hastalık evresi, tümörün histolojik türü, kapsülinvazyonu ve cerrahi sınır durumu, lenfadenektomi, adjuvan radyoterapiveya kemoterapi, cerrahiden adjuvan tedavinin ilk gününe kadar geçen süre,hastanede yatış süresi ve genel ve hastalıksız sağkalım oranları kaydedildi. Bulgular: Hastaların 91’inde Evre II, 67’sinde Evre III ve 45’inde Evre IVhastalık izlendi. Toplam 123 hastada (%61) myastenia gravis vardı. Yetmişaltı hastaya adjuvan radyoterapi ve 48 hastaya neoadjuvan (n=35) veya adjuvan(n=25) kemoterapi verildi. Yüksek hastalık evresi, R1 rezeksiyon varlığı vekemoterapi azalmış hastalıksız sağkalım süresinin anlamlı faktörleriydi.İleri yaş, yüksek hastalık evresi, ameliyat sonrası uzun süreli hastane yatışı,kemoterapi ve hastalık nüksü genel sağkalım süresinin azalmasına katkıdabulunan faktörlerdi. Yalnızca tam rezeke Evre IV hastalığı olan hastalarda,adjuvan radyoterapinin genel sağkalım üzerinde istatistiksel olarak anlamlıbir pozitif etkisi vardı (beş yıllık genel sağkalım: sırasıyla %79.1’e kıyasla%94.7; p=0.015). Çok değişkenli analizde ileri yaş (risk oranı: 4.26),yüksek hastalık evresi (risk oranı: 2.95) ve daha uzun hastanede yatış süresi(risk oranı: 3.81) genel sağkalımın anlamlı prognostik faktörleriydi. Tamrezeksiyon uygulanmış lokal nüks saptanan hastalardaki sağkalım süresi, hiçnüks saptanmayan hastalar ile benzer bulundu (p=0.753). So­nuç: Timomalı hastalarda yüksek hastalık evresi, ≥50 yaş, daha uzun sürelihastanede yatış ve kemoterapi ihtiyacı, daha kötü sağkalım oranları ile ilişkilidir.Adjuvan radyoterapi, Evre IV hastalık üzerinde olumlu etkiye sahiptir. Tekrarlayanlezyonların rezeksiyonunun sağkalım üzerinde önemli bir etkisi vardır.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Ak N, Ferhatoglu F, Aydın E, VATANSEVER S, Eralp Y, Aydiner A, Toker A, KARA M, Ozkan B, Ülker M, karaman s, Dagoglu N, Kaytan Saglam E, Kizir A, bayraktar s, Kaba E, Yegen G, DİŞÇİ R (2021). Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center. , 487 - 495. 10.5606/tgkdc.dergisi.2021.20529
Chicago Ak Naziye,Ferhatoglu Ferhat,Aydın Esra,VATANSEVER SEZAI,Eralp Yesim,Aydiner Adnan,Toker Alper,KARA MURAT,Ozkan Berker,Ülker Melike Güler,karaman sule,Dagoglu Nergiz,Kaytan Saglam Esra,Kizir Ahmet,bayraktar soley,Kaba Erkan,Yegen Gulcin,DİŞÇİ RIAN Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center. (2021): 487 - 495. 10.5606/tgkdc.dergisi.2021.20529
MLA Ak Naziye,Ferhatoglu Ferhat,Aydın Esra,VATANSEVER SEZAI,Eralp Yesim,Aydiner Adnan,Toker Alper,KARA MURAT,Ozkan Berker,Ülker Melike Güler,karaman sule,Dagoglu Nergiz,Kaytan Saglam Esra,Kizir Ahmet,bayraktar soley,Kaba Erkan,Yegen Gulcin,DİŞÇİ RIAN Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center. , 2021, ss.487 - 495. 10.5606/tgkdc.dergisi.2021.20529
AMA Ak N,Ferhatoglu F,Aydın E,VATANSEVER S,Eralp Y,Aydiner A,Toker A,KARA M,Ozkan B,Ülker M,karaman s,Dagoglu N,Kaytan Saglam E,Kizir A,bayraktar s,Kaba E,Yegen G,DİŞÇİ R Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center. . 2021; 487 - 495. 10.5606/tgkdc.dergisi.2021.20529
Vancouver Ak N,Ferhatoglu F,Aydın E,VATANSEVER S,Eralp Y,Aydiner A,Toker A,KARA M,Ozkan B,Ülker M,karaman s,Dagoglu N,Kaytan Saglam E,Kizir A,bayraktar s,Kaba E,Yegen G,DİŞÇİ R Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center. . 2021; 487 - 495. 10.5606/tgkdc.dergisi.2021.20529
IEEE Ak N,Ferhatoglu F,Aydın E,VATANSEVER S,Eralp Y,Aydiner A,Toker A,KARA M,Ozkan B,Ülker M,karaman s,Dagoglu N,Kaytan Saglam E,Kizir A,bayraktar s,Kaba E,Yegen G,DİŞÇİ R "Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center." , ss.487 - 495, 2021. 10.5606/tgkdc.dergisi.2021.20529
ISNAD Ak, Naziye vd. "Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center". (2021), 487-495. https://doi.org/10.5606/tgkdc.dergisi.2021.20529
APA Ak N, Ferhatoglu F, Aydın E, VATANSEVER S, Eralp Y, Aydiner A, Toker A, KARA M, Ozkan B, Ülker M, karaman s, Dagoglu N, Kaytan Saglam E, Kizir A, bayraktar s, Kaba E, Yegen G, DİŞÇİ R (2021). Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 29(4), 487 - 495. 10.5606/tgkdc.dergisi.2021.20529
Chicago Ak Naziye,Ferhatoglu Ferhat,Aydın Esra,VATANSEVER SEZAI,Eralp Yesim,Aydiner Adnan,Toker Alper,KARA MURAT,Ozkan Berker,Ülker Melike Güler,karaman sule,Dagoglu Nergiz,Kaytan Saglam Esra,Kizir Ahmet,bayraktar soley,Kaba Erkan,Yegen Gulcin,DİŞÇİ RIAN Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center. Türk Göğüs Kalp Damar Cerrahisi Dergisi 29, no.4 (2021): 487 - 495. 10.5606/tgkdc.dergisi.2021.20529
MLA Ak Naziye,Ferhatoglu Ferhat,Aydın Esra,VATANSEVER SEZAI,Eralp Yesim,Aydiner Adnan,Toker Alper,KARA MURAT,Ozkan Berker,Ülker Melike Güler,karaman sule,Dagoglu Nergiz,Kaytan Saglam Esra,Kizir Ahmet,bayraktar soley,Kaba Erkan,Yegen Gulcin,DİŞÇİ RIAN Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.29, no.4, 2021, ss.487 - 495. 10.5606/tgkdc.dergisi.2021.20529
AMA Ak N,Ferhatoglu F,Aydın E,VATANSEVER S,Eralp Y,Aydiner A,Toker A,KARA M,Ozkan B,Ülker M,karaman s,Dagoglu N,Kaytan Saglam E,Kizir A,bayraktar s,Kaba E,Yegen G,DİŞÇİ R Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2021; 29(4): 487 - 495. 10.5606/tgkdc.dergisi.2021.20529
Vancouver Ak N,Ferhatoglu F,Aydın E,VATANSEVER S,Eralp Y,Aydiner A,Toker A,KARA M,Ozkan B,Ülker M,karaman s,Dagoglu N,Kaytan Saglam E,Kizir A,bayraktar s,Kaba E,Yegen G,DİŞÇİ R Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2021; 29(4): 487 - 495. 10.5606/tgkdc.dergisi.2021.20529
IEEE Ak N,Ferhatoglu F,Aydın E,VATANSEVER S,Eralp Y,Aydiner A,Toker A,KARA M,Ozkan B,Ülker M,karaman s,Dagoglu N,Kaytan Saglam E,Kizir A,bayraktar s,Kaba E,Yegen G,DİŞÇİ R "Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 29, ss.487 - 495, 2021. 10.5606/tgkdc.dergisi.2021.20529
ISNAD Ak, Naziye vd. "Outcomes of thymoma after multimodal therapy and determinants of survival:A 16-year experience of a tertiary cancer center". Türk Göğüs Kalp Damar Cerrahisi Dergisi 29/4 (2021), 487-495. https://doi.org/10.5606/tgkdc.dergisi.2021.20529