{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:48:00Z","timestamp":1760161680700,"version":"3.40.5"},"reference-count":47,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T00:00:00Z","timestamp":1567987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The current staging systems do not consider the tumor location of thymomas, and its clinical relevance is poorly understood. This study aimed to evaluate the impact of tumor location on the clinicopathological features and prognosis of thymomas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective review of patients at our institution who underwent an extended thymectomy for a thymoma from 1976 to 2015. The tumor location was classified as either the superior or inferior mediastinum based on the maximum tumor diameter. The clinicopathological characteristics of the thymoma were also evaluated. Kaplan\u2010Meier estimates and Cox proportional hazards models were used to analyze the survival outcomes and risk factors for recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 194 patients with thymoma were eligible for this study. Compared with the inferior mediastinum group (<jats:italic>n<\/jats:italic> = 167), the superior mediastinum group (<jats:italic>n<\/jats:italic> = 27) had a higher frequency of myasthenia gravis (MG), advanced Masaoka\u2010Koga staging, disease progression and recurrence (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The Kaplan\u2010Meier analysis demonstrated thymomas in the superior mediastinum had worse survival outcomes that included overall survival, progression\u2010free survival and disease\u2010free survival (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The multivariate analysis showed tumor location was an independent prognostic factor for all the survival outcomes (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Furthermore, the tumor location (<jats:italic>P<\/jats:italic> = 0.004) and Masaoka\u2010Koga stage (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) were the only two independent risk factors for recurrence in the multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The clinicopathological features of thymomas on MG, Masaoka\u2010Koga staging, disease progression, and recurrence were different between locations of superior and inferior mediastinum locations. Thymomas in the superior mediastinum tended to be associated with worse survival and increased recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.13188","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T23:49:03Z","timestamp":1568072943000},"page":"2096-2105","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Tumor location may affect the clinicopathological features and prognosis of thymomas"],"prefix":"10.1111","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8510-8309","authenticated-orcid":false,"given":"Dong","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery The University of Tokyo Graduate School of Medicine  Tokyo Japan"},{"name":"Department of Thoracic Surgery Affiliated Hospital of North Sichuan Medical College  Nanchong China"},{"name":"Department of Thoracic Surgery, West China Hospital Sichuan University  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