Type B thymoma: Is prognosis predicted only by World Health Organization classification?
Received 12 May 2009; received in revised form 10 September 2009; accepted 8 October 2009. published online 28 December 2009.
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.
aDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
bDepartment of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Address for reprints: Kwhanmien Kim, MD, Professor, Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Korea.
ABSTRACT