Neoadjuvant therapy for thymic neoplasms reduces tumor volume per 3D-reconstructed images but does not improve the complete resection rate

Jee Won Suh, Seong Yong Park, Chang Young Lee, Seung Hwan Song, Dae Joon Kim, Hyo Chae Paik, Kyoung Young Chung, Min Hee Hong, Hye Ryun Kim, ByoungChul Cho, Jin Gu Lee

Research output: Contribution to journalArticle

Abstract

Objectives Complete resection of thymic neoplasms is important for achieving a favorable prognosis; however, the efficacy of neoadjuvant therapy remains controversial. We investigated the effect of induction therapy on complete resection and survival using 3-dimensionally reconstructed images to measure tumor volume. Methods Eighty-nine patients who underwent surgical resection for Masaoka-Koga stage III–IV thymic neoplasms between January 2000 and December 2013 were enrolled, including 71 and 18 in the primary surgery and neoadjuvant therapy groups, respectively. Baseline characteristics, postoperative outcomes, and survival rates were analyzed. Moreover, baseline and post-neoadjuvant therapy tumor volumes were compared among patients in the neoadjuvant group. Results Adjacent mediastinal structure invasion was significantly rarer in the primary surgery group than in the neoadjuvant group (1.27±1.09 vs. 2.61±1.42, p<0.001). On subgroup analysis of patients who underwent neoadjuvant therapy, tumor volumes decreased significantly from 206.08±132.32 cm 3 to 81.25±71.24 cm 3 post-therapy (p = 0.001). Interestingly, only the pre-neoadjuvant tumor volume was significantly associated with complete resection, while the post-neoadjuvant volume was not (p = 0.012 and p = 0.458, respectively). Moreover, despite significantly reduced tumor volumes, patients in the neoadjuvant therapy group did not exhibit significantly different R0 resection rates (odds ratio 1.490, p = 0.581) or overall survival (p = 0.285) compared to those in the primary surgery group. Conclusions Neoadjuvant therapy does not significantly influence the R0 resection rate or overall survival relative to primary surgery. Nevertheless, it may by useful for patients planning surgical resection because it significantly reduces the presurgical tumor volume and extent of invasion.

Original languageEnglish
Article numbere0214291
JournalPloS one
Volume14
Issue number3
DOIs
Publication statusPublished - 2019 Mar 1

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Thymus Neoplasms
Neoadjuvant Therapy
resection
Tumor Burden
Tumors
therapeutics
Surgery
neoplasms
surgery
Survival
Survival Rate
Odds Ratio
odds ratio
prognosis
Planning
planning
survival rate
Therapeutics

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Suh, Jee Won ; Park, Seong Yong ; Lee, Chang Young ; Song, Seung Hwan ; Kim, Dae Joon ; Paik, Hyo Chae ; Chung, Kyoung Young ; Hong, Min Hee ; Kim, Hye Ryun ; Cho, ByoungChul ; Lee, Jin Gu. / Neoadjuvant therapy for thymic neoplasms reduces tumor volume per 3D-reconstructed images but does not improve the complete resection rate. In: PloS one. 2019 ; Vol. 14, No. 3.
@article{1c528c9bed3e414c9f9b2fb01b98b83d,
title = "Neoadjuvant therapy for thymic neoplasms reduces tumor volume per 3D-reconstructed images but does not improve the complete resection rate",
abstract = "Objectives Complete resection of thymic neoplasms is important for achieving a favorable prognosis; however, the efficacy of neoadjuvant therapy remains controversial. We investigated the effect of induction therapy on complete resection and survival using 3-dimensionally reconstructed images to measure tumor volume. Methods Eighty-nine patients who underwent surgical resection for Masaoka-Koga stage III–IV thymic neoplasms between January 2000 and December 2013 were enrolled, including 71 and 18 in the primary surgery and neoadjuvant therapy groups, respectively. Baseline characteristics, postoperative outcomes, and survival rates were analyzed. Moreover, baseline and post-neoadjuvant therapy tumor volumes were compared among patients in the neoadjuvant group. Results Adjacent mediastinal structure invasion was significantly rarer in the primary surgery group than in the neoadjuvant group (1.27±1.09 vs. 2.61±1.42, p<0.001). On subgroup analysis of patients who underwent neoadjuvant therapy, tumor volumes decreased significantly from 206.08±132.32 cm 3 to 81.25±71.24 cm 3 post-therapy (p = 0.001). Interestingly, only the pre-neoadjuvant tumor volume was significantly associated with complete resection, while the post-neoadjuvant volume was not (p = 0.012 and p = 0.458, respectively). Moreover, despite significantly reduced tumor volumes, patients in the neoadjuvant therapy group did not exhibit significantly different R0 resection rates (odds ratio 1.490, p = 0.581) or overall survival (p = 0.285) compared to those in the primary surgery group. Conclusions Neoadjuvant therapy does not significantly influence the R0 resection rate or overall survival relative to primary surgery. Nevertheless, it may by useful for patients planning surgical resection because it significantly reduces the presurgical tumor volume and extent of invasion.",
author = "Suh, {Jee Won} and Park, {Seong Yong} and Lee, {Chang Young} and Song, {Seung Hwan} and Kim, {Dae Joon} and Paik, {Hyo Chae} and Chung, {Kyoung Young} and Hong, {Min Hee} and Kim, {Hye Ryun} and ByoungChul Cho and Lee, {Jin Gu}",
year = "2019",
month = "3",
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Suh, JW, Park, SY, Lee, CY, Song, SH, Kim, DJ, Paik, HC, Chung, KY, Hong, MH, Kim, HR, Cho, B & Lee, JG 2019, 'Neoadjuvant therapy for thymic neoplasms reduces tumor volume per 3D-reconstructed images but does not improve the complete resection rate', PloS one, vol. 14, no. 3, e0214291. https://doi.org/10.1371/journal.pone.0214291

Neoadjuvant therapy for thymic neoplasms reduces tumor volume per 3D-reconstructed images but does not improve the complete resection rate. / Suh, Jee Won; Park, Seong Yong; Lee, Chang Young; Song, Seung Hwan; Kim, Dae Joon; Paik, Hyo Chae; Chung, Kyoung Young; Hong, Min Hee; Kim, Hye Ryun; Cho, ByoungChul; Lee, Jin Gu.

In: PloS one, Vol. 14, No. 3, e0214291, 01.03.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Neoadjuvant therapy for thymic neoplasms reduces tumor volume per 3D-reconstructed images but does not improve the complete resection rate

AU - Suh, Jee Won

AU - Park, Seong Yong

AU - Lee, Chang Young

AU - Song, Seung Hwan

AU - Kim, Dae Joon

AU - Paik, Hyo Chae

AU - Chung, Kyoung Young

AU - Hong, Min Hee

AU - Kim, Hye Ryun

AU - Cho, ByoungChul

AU - Lee, Jin Gu

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Objectives Complete resection of thymic neoplasms is important for achieving a favorable prognosis; however, the efficacy of neoadjuvant therapy remains controversial. We investigated the effect of induction therapy on complete resection and survival using 3-dimensionally reconstructed images to measure tumor volume. Methods Eighty-nine patients who underwent surgical resection for Masaoka-Koga stage III–IV thymic neoplasms between January 2000 and December 2013 were enrolled, including 71 and 18 in the primary surgery and neoadjuvant therapy groups, respectively. Baseline characteristics, postoperative outcomes, and survival rates were analyzed. Moreover, baseline and post-neoadjuvant therapy tumor volumes were compared among patients in the neoadjuvant group. Results Adjacent mediastinal structure invasion was significantly rarer in the primary surgery group than in the neoadjuvant group (1.27±1.09 vs. 2.61±1.42, p<0.001). On subgroup analysis of patients who underwent neoadjuvant therapy, tumor volumes decreased significantly from 206.08±132.32 cm 3 to 81.25±71.24 cm 3 post-therapy (p = 0.001). Interestingly, only the pre-neoadjuvant tumor volume was significantly associated with complete resection, while the post-neoadjuvant volume was not (p = 0.012 and p = 0.458, respectively). Moreover, despite significantly reduced tumor volumes, patients in the neoadjuvant therapy group did not exhibit significantly different R0 resection rates (odds ratio 1.490, p = 0.581) or overall survival (p = 0.285) compared to those in the primary surgery group. Conclusions Neoadjuvant therapy does not significantly influence the R0 resection rate or overall survival relative to primary surgery. Nevertheless, it may by useful for patients planning surgical resection because it significantly reduces the presurgical tumor volume and extent of invasion.

AB - Objectives Complete resection of thymic neoplasms is important for achieving a favorable prognosis; however, the efficacy of neoadjuvant therapy remains controversial. We investigated the effect of induction therapy on complete resection and survival using 3-dimensionally reconstructed images to measure tumor volume. Methods Eighty-nine patients who underwent surgical resection for Masaoka-Koga stage III–IV thymic neoplasms between January 2000 and December 2013 were enrolled, including 71 and 18 in the primary surgery and neoadjuvant therapy groups, respectively. Baseline characteristics, postoperative outcomes, and survival rates were analyzed. Moreover, baseline and post-neoadjuvant therapy tumor volumes were compared among patients in the neoadjuvant group. Results Adjacent mediastinal structure invasion was significantly rarer in the primary surgery group than in the neoadjuvant group (1.27±1.09 vs. 2.61±1.42, p<0.001). On subgroup analysis of patients who underwent neoadjuvant therapy, tumor volumes decreased significantly from 206.08±132.32 cm 3 to 81.25±71.24 cm 3 post-therapy (p = 0.001). Interestingly, only the pre-neoadjuvant tumor volume was significantly associated with complete resection, while the post-neoadjuvant volume was not (p = 0.012 and p = 0.458, respectively). Moreover, despite significantly reduced tumor volumes, patients in the neoadjuvant therapy group did not exhibit significantly different R0 resection rates (odds ratio 1.490, p = 0.581) or overall survival (p = 0.285) compared to those in the primary surgery group. Conclusions Neoadjuvant therapy does not significantly influence the R0 resection rate or overall survival relative to primary surgery. Nevertheless, it may by useful for patients planning surgical resection because it significantly reduces the presurgical tumor volume and extent of invasion.

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U2 - 10.1371/journal.pone.0214291

DO - 10.1371/journal.pone.0214291

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