{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:06:31Z","timestamp":1789545991387,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The role of peri\u2010operative radiation therapy in thymic epithelial tumors remains controversial, and randomized data are lacking. The authors evaluated recurrence patterns, pathologic predictors of recurrence, and long\u2010term survival among patients who underwent surgery and received peri\u2010operative radiation at a high\u2010volume tertiary center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors conducted a retrospective cohort study of patients who had thymic malignancies treated surgically between 2004 and 2021. Clinical, pathologic, and treatment data were collected. Outcomes were assessed using Kaplan\u2013Meier and Cox regression methods, and propensity score overlap weighting was applied to adjust for baseline differences between the radiation and no\u2010radiation groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 360 patients were included, of whom 175 (48.6%) received peri\u2010operative radiation. Among irradiated patients, 62 (35.4%) developed recurrence, most commonly in the pleura (76%); in\u2010field recurrences were rare (5%). Tumor invasiveness was the strongest predictor of recurrence, particularly vascular invasion (odds ratio, 6.0; 95% confidence interval, 2.3\u201315.7). Histologic subtype was not associated with recurrence. Survival did not differ between groups on unadjusted comparison (hazard ratio, 1.02; 95% confidence interval, 0.63\u20131.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.93). After overlap weighting, radiation was associated with overall survival (hazard ratio, 0.49; 95% CI, 0.26\u20130.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with surgically treated thymic malignancies, tumor invasiveness, especially vascular invasion, was the strongest predictor of recurrence and should guide risk stratification. Failure was predominantly pleural, with rare in\u2010field recurrence, indicating good local control but a need for better strategies against pleural relapse. Survival benefit from peri\u2010operative radiation remains uncertain and should be tested prospectively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70595","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:12:36Z","timestamp":1788459156000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term outcomes and patterns of failure in patients with thymic malignancies treated with surgery and radiation therapy"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9857-877X","authenticated-orcid":false,"given":"Oded","family":"Icht","sequence":"first","affiliation":[{"name":"Radiation Medicine Program Princess Margaret Cancer Centre University Health Network  Toronto Ontario Canada"},{"name":"Department of Radiation Oncology University of Toronto  Toronto Ontario Canada"},{"name":"Gray Faculty of Medical and Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inbar","family":"Nardi\u2010Agmon","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"Department of Medicine Division of Cardiology Ted Rogers Program in Cardiotoxicity Prevention Peter Munk Cardiac Center Toronto General Hospital University Health Network University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paaladinesh","family":"Thavendiranathan","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology Ted Rogers Program in Cardiotoxicity Prevention Peter Munk Cardiac Center Toronto General Hospital University Health Network University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaf","family":"Keshavjee","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery University of Toronto Toronto General Hospital and Princess Margaret Cancer Centre University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amiya","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Radiation Medicine Program Princess Margaret Cancer Centre University Health Network  Toronto Ontario Canada"},{"name":"Department of Radiation Oncology University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John\u2010Michael","family":"Miro","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Princess Margaret Cancer Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Badran","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Princess Margaret Cancer Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Princess Margaret Cancer Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang Y.","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Princess Margaret Cancer Centre University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. 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