Abbreviations:(TETs) (Thymic epithelial tumors), (SEER) (Surveillance, Epidemiology, and End Results), (NCI) (National Cancer Institute), (OS) (Overall survival), (DSS) (Disease-specific survival), (PORT) (postoperative radiotherapy), (TNM) (tumor-node-metastasis), (ICD) (International Classification of Diseases), (IASLC) (International Association for the Study of Lung Cancer), (ITMIG) (International Thymic Malignancy Interest Group), (NCCN) (National Comprehensive Cancer Network), (ESMO) (European Society for Medical Oncology), (NOS) (not otherwise specified), (HR) (Hazard ratio), (CI) (Confidence intervals)
Publication stageIn Press Journal Pre-Proof
Conflict of interest statement: Authors have nothing to disclose.
Funding statement: This research was supported by the National Natural Science Foundation of China (Grant Nos. 82172848), Shanghai Rising-Star Program (Grant No. 19QA1407400), Shanghai Municipal Education Commission “Chen Guang” project (19CG19), Shanghai "Rising Stars of Medical Talent" Youth Development Program Youth Medical Talents - Specialist Program, Shanghai Pulmonary Hospital Fund for Excellent Young Scholars (No. fkyq1908), Shanghai Pulmonary Hospital Fund (fkzr2105 and fkyq1908).
Central Message: Postoperative radiotherapy for patients with regional invasion and type B2/B3 thymoma who undergo thymectomy/thymomectomy could significantly improve the disease-specific survival.
Perspective Statement: PORT should be considered in tumors with advanced stage using NCCN guidelines or aggressive histology per ESMO recommendations. Extent of resection should also be considered as PORT was associated with better survival in thymoma with regional invasion and type B2/B3. Additionally, multi-modality therapy should be given in thymoma with lymphogenous metastases.
Abbreviated legend for our Central Picture: The comparison between clinical guidelines and our study.
In light of different criteria for recommending PORT after thymoma resection, our study found that extent of resection, stage, and histology should be considered in the decision to administer PORT. Multi-modality therapy should be considered in patients with lymphogenous metastases.
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