The secondary surgery provides significant benefits to recurrent thymoma: a retrospective analysis based on Surveillance, Epidemiology and End Results database

Dongliang Bian, Tao Ge, Nan Song, Peng Zhang, Helin Zhang, Ke Fei


Background: Recurrent thymoma (RT) with appropriate therapies has acceptable survival. The role of secondary surgery for RT remains controversial.
Methods: Surgical treated thymoma patients were reviewed from Surveillance, Epidemiology and End Results database (SEER). Propensity score matching (PSM) was utilized to match baseline factors to balance secondary surgical treated RT and thymoma without recurrence (NRT). Univariate and multivariate analyses were performed to evaluate the role of secondary surgery for RT.
Results: According to analysis, 815 patients were NRT, and 185 were RT. Surgical treated RT had significantly better overall survival (OS) than conservative treated RT (P<0.001). Survival between surgical treated RT and NRT had no significant difference. Focused on surgical treated RT and NRT, after PSM, elder diagnostic age, advanced clinical stage, upgraded pathologic grade predicted worse OS (P<0.01, for all), whereas, secondary surgery for RT provided comparable outcomes to NRT.
Conclusions: Masaoka stage I–III RT with secondary surgery causes acceptable outcomes compared to NRT. In addition, elder patients, advanced Masaoka stage, upgraded pathologic grade, and without PORT indicate significantly worse OS in thymoma.