ArticleJournal of thoracic disease2025
The role of adjuvant chemotherapy in patients with thymoma and thymic carcinoma following surgery: a systematic literature review and meta-analysis.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The significance of postoperative chemotherapy (POCT) in patients with thymoma and thymic carcinoma remains uncertain. This meta-analysis aims to evaluate the role of POCT in improving overall survival (OS) or disease-free survival (DFS) in patients with thymoma and thymic carcinoma. Methods: A systematic review was conducted, including 11 articles published before October 2023, with a focus on thymoma (3 articles) and thymic carcinoma (8 articles). We performed bias assessment and meta-analysis effect size pooling using StateSe and Review Manager software. The random-effects model was employed to account for heterogeneity, and a significance level of P≤0.05 was considered statistically significant. Results: Compared with non-POCT for thymoma and thymic carcinoma, POCT did not improve OS or DFS [hazard ration (HR) =0.87, 95% confidence interval (CI): 0.68-1.10; P=0.23 and HR =0.92, 95% CI: 0.54-1.58; P=0.76, respectively]. Similarly, compared with non-POCT in patients with thymoma, POCT did not improve OS or DFS (HR =1.23, 95% CI: 0.63-2.40; P=0.55 and HR =0.50, 95% CI: 0.06-3.97; P=0.52, respectively). For patients with thymic carcinoma, POCT can improve the prognosis and the OS rate significantly (HR =0.67, 95% CI: 0.50-0.89; P=0.006), but not the DFS time (HR =1.03, 95% CI: 0.57-1.88; P=0.91). Conclusions: Notably, POCT did not have a significant impact on DFS in patients with thymoma or thymic carcinoma. These findings suggest that postoperative adjuvant chemotherapy may not be necessary for advanced thymoma patients but can be beneficial for those with thymic carcinoma.
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