Type B thymoma: Is prognosis predicted only by World Health Organization classification?

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• 作者：Hong Kwan Kim ; Yong Soo Choi ; Jhingook Kim ; Young Mog Shim ; Joungho Han ; Kwhanmien Kim
• 刊名：The Journal of Thoracic and Cardiovascular Surgery
• 出版年：2010
• 出版时间：June 2010
• 年：2010
• 卷：139
• 期：6
• 页码：1431-1435.e1
• 全文大小：312 K

文摘

Objective

The prognostic relevance of subtypes within type B thymomas is controversial. The objective of this study was to evaluate the utility of World Health Organization (WHO) classification in patients with type B thymoma.

Methods

This was a retrospective review of 100 patients who underwent thymectomy for WHO type B thymoma. Recurrence patterns and survival were compared among subtypes.

Results

There were 22 type B1 tumors, 43 type B2 tumors, and 35 type B3 tumors. Incomplete resection occurred in 5 patients with type B1 thymoma, 8 with type B2 thymoma, and 8 with type B3 thymoma (P = .87). Of the 79 patients with complete resection, tumor recurrence occurred in 1 (5.9 % ) patient with type B1 thymoma, 2 (5.7 % ) with type B2 thymoma, and 2 (7.4 % ) with type B3 thymoma, and all of these patients had Masaoka stage III disease. Disease-free survival at 5 years was 93 % , 85 % , and 82 % in type B1, B2, and B3, respectively (B1 vs B2; P = .79; B2 vs B3; P = 0.6). Disease-free survival at 5 years was 94 % , 100 % , 61 % , and 50 % in Masaoka stages I, II, III, and IV, respectively (I vs II; P = .26; II vs III; P = .028; III vs IV; P = .002).

Conclusions

Tumor recurrence was significantly associated with advanced Masaoka stage regardless of the WHO subtype of type B thymomas. Given the heterogeneity of WHO type B thymomas, Masaoka stage should always be considered when predicting prognosis and planning adjuvant treatment for patients with type B thymomas.