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    Factors Affecting Treatment and Prognosis in Thymomas: A Multi-Center Experience
    (Kare Publ, 2020) Karabulut Gul, Sule; Tepetam, Huseyin; Karaman, Sule; Gurocak, Simay; Korkmaz Kirakli, Esra; Babalioglu, Ibrahim; Erdis, Eda
    OBJECTIVE Thymomas, a rare malignancy, are located in 95% anterior mediastinum. They are associated with paraneoplastic syndromes, especially myasthenia graves. Although many classifications are used considering the depth of invasion, presence of metastasis, predominant cell type, or immunohistochemical properties in staging, Masoaka classification is commonly used. Surgery is the most effective method in the treatment of thymoma, and neoadjuvant chemotherapy is recommended in advanced stages (III-IV). Adjuvant radiotherapy has proven efficacy in advanced and inoperable patients. In this study, we aimed to evaluate treatment outcomes and factors affecting prognosis in thymoma patients. METHODS Patients with thymoma who were included in this study voluntarily from seven centers between January 2002 and August 2018 were evaluated retrospectively. RESULTS Of the 158 patients with thymoma, 125 patients with complete data were included in this study. The mean age of the patients was 51.84 (18-84), and 72 were male. Myasthenia graves were present in 64 patients. One hundred thirteen patients were operated and 12 were inoperable. One hundred patients were stage 2, 9 were stage 3, and 16 were stage 4. In our study, 3-year survival was 84.4%, and 5-year survival was 74.9%; inoperable patients, surgical margin positivity, advanced disease and radiotherapy dose less than 50.4'Gy were found to be negative factors affecting survival. In patients with myasthenia graves (MG), survival was higher in patients with stage 2B and less. Survival was lower in epithelial type B3 and type C histologic types. Age, sex, and capsule involvement did not seem to affect survival. CONCLUSION Thymoma is a locally controlled disease with long survival and the results of our study are consistent with the literature. The number of patients should be increased to better define prognostic factors.