Original article: general thoracicAdjuvant radiation therapy for stage II thymoma
Section snippets
Patient population and follow-up
After approval from the Institutional Review Board, the surgical logs and pathology files at the Massachusetts General Hospital were retrospectively reviewed between 1972 and 1999. One hundred fifty-five patients underwent thymoma resection. Of these, 49 had stage II disease and form the basis for this report. Hospital and office medical records were reviewed, and demographic and tumor-related data were entered into a computerized database. Patient follow-up was obtained by review of hospital
Results
The median age at diagnosis was 56 years (range, 13 to 82 years). Twenty-seven (55%) patients were male. Sixteen patients (32.7%) had myasthenia gravis. There were no significant demographic differences between radiated and nonradiated patients.
Surgery was offered as initial treatment to all patients. Seven surgeons performed thymoma resection with total thymectomy via median sternotomy. All 49 patients with stage II disease underwent complete resection, with negative microscopic margins.
Comment
The most important determinants of long-term survival in thymoma are completeness of resection [11], Masaoka stage [15], and Mueller-Hermelink histologic classification 16, 17, 18, 19, 20. The prognostic importance of these determinants has been verified in several large studies. Unfortunately, recommendations for the appropriate use of adjuvant radiation therapy for stage II thymoma are wide ranging and controversial. Current recommendations advocate radiation of all patients with stage II
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