Postoperative radiation therapy and overall survival in completely resected stage II and III thymoma: analysis of the International Thymic Malignancy Interest Group retrospective database
Phase observationalN = 1,263
- Population
- 1,263 patients with completely resected (R0) stage II or III thymoma; 870 (69%) had stage II; WHO subtype A or AB in 360 (30%) and B1, B2 or B3 in 827 (70%)
- Design
- Retrospective analysis of the International Thymic Malignancy Interest Group (ITMIG) database (39 institutions; patients treated 1990 to 2012). All patients with completely resected (R0) Masaoka or Masaoka-Koga stage II or III thymoma were identified; OS was the primary end point (log-rank test; multivariate Cox model). Not randomised. PORT was given to 55% (689 patients), chemotherapy to 15% (180) and both to 10% (122). In the full text, patients who received PORT were younger, more often male, more often had myasthenia gravis, stage III disease, larger tumours and WHO B1-B3 histology than those who did not.
- Primary endpoint
- OS
- Arms
- Operation alone (control, n = 574): Complete resection without postoperative radiotherapy
- Operation plus PORT (experimental, n = 689): Complete resection followed by postoperative radiotherapy (dose and technique not stated in the abstract)
- People
- Rimner A, senior author Gomez DR, International Thymic Malignancy Interest Group (ITMIG)
Δ 60-month OS+5 points
Show the numbers
| Endpoint | Analysis | Operation plus PORT | Operation alone | Effect |
|---|---|---|---|---|
| OSCompletely resected (R0) Masaoka or Masaoka-Koga stage II or III thymoma | finalRimner 2016 | 95% at 5 y; 86% at 10 y | 90% at 5 y; 79% at 10 y | P=0.002Univariate log-rank comparison; observational. The abstract reports the OS difference separately for stage II (p = 0.02) and stage III (p = 0.0005), and that PORT was among the factors significantly associated with improved OS on multivariate analysis (no hazard ratio is given in the abstract). The full text reports stage III 5- and 10-year OS of 92% and 79% with PORT versus 76% and 64% without, and stage II 97% and 91% versus 93% and 83%. Median follow-up of living patients was 4.05 years with PORT and 2.66 years without. |
| Endpoint | Analysis | Operation plus PORT | Operation alone | Effect |
|---|---|---|---|---|
| OSCompletely resected (R0) Masaoka or Masaoka-Koga stage II or III thymoma | finalRimner 2016 | 95% at 5 y; 86% at 10 y | 90% at 5 y; 79% at 10 y | P=0.002Univariate log-rank comparison; observational. The abstract reports the OS difference separately for stage II (p = 0.02) and stage III (p = 0.0005), and that PORT was among the factors significantly associated with improved OS on multivariate analysis (no hazard ratio is given in the abstract). The full text reports stage III 5- and 10-year OS of 92% and 79% with PORT versus 76% and 64% without, and stage II 97% and 91% versus 93% and 83%. Median follow-up of living patients was 4.05 years with PORT and 2.66 years without. |
- Operation plus PORT (experimental)
- Operation alone (control)
Data table (modelled values)
| Months | Operation plus PORT | Operation alone |
|---|---|---|
| 0 | 100.0% | 100.0% |
| 32 | 97.6% | 94.7% |
| 65 | 94.4% | 89.1% |
| 97 | 89.6% | 83.3% |
| 130 | 86.0% | 79.0% |
Appears in
Sources
Rimner A, Yao X, Huang J, Antonicelli A, Ahmad U, Korst RJ, et al. Postoperative Radiation Therapy Is Associated with Longer Overall Survival in Completely Resected Stage II and III Thymoma-An Analysis of the International Thymic Malignancies Interest Group Retrospective Database. J Thorac Oncol. 2016;11(10):1785-92.