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10.1093/ejcts/ezt649

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C4155438!4155438!24482389
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suck abstract from ncbi


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pmid24482389      Eur+J+Cardiothorac+Surg 2014 ; 46 (3): 361-8
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  • Tumours of the thymus: a cohort study of prognostic factors from the European Society of Thoracic Surgeons database #MMPMID24482389
  • Ruffini E; Detterbeck F; Van Raemdonck D; Rocco G; Thomas P; Weder W; Brunelli A; Evangelista A; Venuta F; Khaled A; Arame A; Refai M; Casadio C; Carbognani P; Cerfolio R; Donati G; Foroulis CN; Gebitekin C; de Antonio DG; Kernstine KH; Keshavjee S; Moser B; Lequaglie C; Liberman M; Lim E; Nicholson AG; Lang-Lazdunski L; Mancuso M; Altorki N; Nosotti M; Novoa NM; Brioude G; Oliaro A; Filosso PL; Saita S; Scarci M; Schützner J; Terzi A; Toker A; Van Veer H; Anile M; Rendina E; Voltolini L; Zurek W
  • Eur J Cardiothorac Surg 2014[Sep]; 46 (3): 361-8 PMID24482389show ga
  • OBJECTIVES: A retrospective database was developed by the European Society of Thoracic Surgeons, collecting patients submitted to surgery for thymic tumours to analyse clinico-pathological prognostic predictors. METHODS: A total of 2151 incident cases from 35 institutions were collected from 1990 to 2010. Clinical-pathological characteristics were analysed, including age, gender, associated myasthenia gravis stage (Masaoka), World Health Organization histology, type of thymic tumour [thymoma, thymic carcinoma (TC), neuroendocrine thymic tumour (NETT)], type of resection (complete/incomplete), tumour size, adjuvant therapy and recurrence. Primary outcome was overall survival (OS); secondary outcomes were the proportion of incomplete resections, disease-free survival and the cumulative incidence of recurrence (CIR). RESULTS: A total of 2030 patients were analysed for OS (1798 thymomas, 191 TCs and 41 NETTs). Ten-year OS was 0.73 (95% confidence interval 0.69?0.75). Complete resection (R0) was achieved in 88% of the patients. Ten-year CIR was 0.12 (0.10?0.15). Predictors of shorter OS were increased age (P < 0?001), stage [III vs I HR 2.66, 1.80?3.92; IV vs I hazard ratio (HR) 4.41, 2.67?7.26], TC (HR 2.39, 1.68?3.40) and NETT (HR 2.59, 1.35?4.99) vs thymomas and incomplete resection (HR 1.74, 1.18?2.57). Risk of recurrence increased with tumour size (P = 0.003), stage (III vs I HR 5.67, 2.80?11.45; IV vs I HR 13.08, 5.70?30.03) and NETT (HR 7.18, 3.48?14.82). Analysis using a propensity score indicates that the administration of adjuvant therapy was beneficial in increasing OS (HR 0.69, 0.49?0.97) in R0 resections. CONCLUSIONS: Masaoka stages III?IV, incomplete resection and non-thymoma histology showed a significant impact in increasing recurrence and in worsening survival. The administration of adjuvant therapy after complete resection is associated with improved survival.
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