Survival Outcomes in Patients with Thymoma after Thymectomy in an Indian Scenario
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ORIGINAL ARTICLE
Survival Outcomes in Patients with Thymoma after Thymectomy in an Indian Scenario Anvesh Dharanikota 1
&
Ravi Arjunan 1 & Ramachandra Chowdappa 1 & Syed Althaf 1
Received: 30 April 2020 / Accepted: 10 November 2020 / Published online: 20 November 2020 # Indian Association of Surgical Oncology 2020
Abstract Thymomas are relatively slow growing with late presentation. Because of rarity and underreporting in India, there is an unmet need for evaluating the patient characteristics and assessing the factors affecting survival for standardizing the ideal modality of treatment in Indian population. A retrospective analysis of 96 patients with thymoma was done between 1998 and 2018. Patient characteristics, histopathological characteristics, operative outcomes, local recurrences, and survival outcomes were recorded. Survival analysis was done using Kaplan-Meier method, and statistical data were analyzed using SPSS version 25 (IBM). The incidence of thymoma was relatively high in 6th decade with no sex predilection. Common presenting symptoms were cough and dyspnea. Myasthenia gravis was noted in 30.2%, which resolved after thymectomy in 65.5% of patients. Most patients presented with Masaoka stages I and II, and predominant WHO histological types were B1 and AB. Complete resection was done in 69.8% cases, and local recurrence was noted in 15.6%. Median sternotomy was the most frequently used approach for thymectomy. The 5-year overall survival was 76%, with an excellent 5-year survival of 95% and 86% in stages I and II patients. Masaoka stage, WHO histologic type, completeness of surgery, and local recurrence did affect the survival significantly. Masaoka stages III and IV, histological type B3, incomplete resection during surgery, and presence of local recurrence did independently predict a worse overall survival. Keywords Thymoma . Survival . Prognosis . Myasthenia gravis
Introduction Thymomas are rare malignancies with an annual incidence of 0.15/100,000 population. They arise from the thymic epithelium and constitute 30% and 15% of anterior mediastinal masses in adults and children, respectively [1]. Most of the evidence regarding thymoma came from retrospective studies, owing to its rarity in incidence. The prognostic relevance of patient and tumor-related factors such as age, sex, association with MG, and histologic type is still controversial [2–6]. The prognostic importance of other treatment-related factors, such as incomplete resection, and local recurrence are still not clear [5]. Because of these contradictory data, the relevance of many prognostic factors in thymoma needs * Anvesh Dharanikota [email protected] 1
Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Marigowda Road, Bangalore, Karnataka, India
further elucidation. There is a need for evaluating the factors affecting survival in Indian population as thymomas are grossly underreported. Most of the cancer registries in India do not incorporate data pertaining to thymoma, and only a few articles con
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