{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:08:43Z","timestamp":1788502123544,"version":"build-2803163510"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Xiamen Science and Technology Project","award":["3502Z20194013"],"award-info":[{"award-number":["3502Z20194013"]}]},{"DOI":"10.13039\/501100003392","name":"Natural Science Foundation of Fujian Province","doi-asserted-by":"publisher","award":["2020J011220"],"award-info":[{"award-number":["2020J011220"]}],"id":[{"id":"10.13039\/501100003392","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Key Medical and Health Projects in Xiamen","award":["3502Z20209002"],"award-info":[{"award-number":["3502Z20209002"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>No consensus was reached on the efficacy of postoperative radiotherapy (PORT) in locally invasive thymomas because of the rarity of the thymic epithelial and the variations of study results. Therefore, we aimed to explore the efficacy of PORT in locally invasive thymomas using the Surveillance, Epidemiology, and End Results (SEER) database.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients diagnosed with thymomas from 2004 to 2016 were identified using the SEER database. Prognostic factors of cancer-specific survival (CSS) and overall survival (OS) were identified using univariate and multivariate Cox regression analyses.Propensity score matching (PSM) was performed to balance the baseline characteristics.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 700 eligible patients were identified. After PSM, 262 paired patients were selected from the two groups, those who received or did not receive PORT. Receiving PORT improved CSS and OS before and after PSM. In the matched population, the multivariate analyses showed that tumour invasion into adjacent organs\/structures and non-utilisation of PORT were independent poor prognostic factors for CSS, whereas age \u226562 years,tumour invasion into adjacent organs\/structures, and non-utilisation of PORT were independently associated with poorer OS. The subgroup analysis revealed that PORT improved CSS and OS in Masaoka-Koga stage III thymoma, but showed no OS benefit in Masaoka-Koga stage IIB thymoma.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Based on the SEER database, we found that PORT provides a significant survival benefit in Masaoka-Koga stage III thymoma with complete or incomplete resection. The role of PORT in thymoma requires further evaluation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0283192","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T18:22:08Z","timestamp":1681410128000},"page":"e0283192","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of the role of postoperative radiotherapy in locally invasive thymoma: A propensity-matched study based on the SEER database"],"prefix":"10.1371","volume":"18","author":[{"given":"Li-mei","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-min","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-xia","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zong-kai","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-qing","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3593-0534","authenticated-orcid":true,"given":"Jun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4391-8706","authenticated-orcid":true,"given":"Qin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"issue":"10 Suppl 4","key":"pone.0283192.ref001","doi-asserted-by":"crossref","first-page":"S260","DOI":"10.1097\/JTO.0b013e3181f1f62d","article-title":"Epidemiology of thymoma and associated malignancies","volume":"5","author":"EA Engels","year":"2010","journal-title":"Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer"},{"issue":"3","key":"pone.0283192.ref002","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/S0003-4975(03)00555-1","article-title":"Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan","volume":"76","author":"K Kondo","year":"2003","journal-title":"The Annals of thoracic surgery"},{"issue":"1","key":"pone.0283192.ref003","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ejcts.2009.05.038","article-title":"Thymoma and thymic carcinoma","volume":"37","author":"F Venuta","year":"2010","journal-title":"European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery."},{"issue":"1","key":"pone.0283192.ref004","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1093\/ejcts\/ezu368","article-title":"Does the World Health Organization histological classification predict outcomes after thymomectomy? Results of a multicentre study on 750 patients","volume":"48","author":"F Guerrera","year":"2015","journal-title":"European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery"},{"key":"pone.0283192.ref005","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.critrevonc.2016.01.012","article-title":"Thymoma and thymic carcinomas","volume":"99","author":"M Scorsetti","year":"2016","journal-title":"Critical reviews in oncology\/hematology"},{"issue":"11","key":"pone.0283192.ref006","doi-asserted-by":"crossref","first-page":"2485","DOI":"10.1002\/1097-0142(19811201)48:11<2485::AID-CNCR2820481123>3.0.CO;2-R","article-title":"Follow-up study of thymomas with special reference to their clinical stages","volume":"48","author":"A Masaoka","year":"1981","journal-title":"Cancer"},{"issue":"5","key":"pone.0283192.ref007","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1111\/j.1440-1827.1994.tb02936.x","article-title":"A review of 79 thymomas: modification of staging system and reappraisal of conventional division into invasive and non-invasive thymoma","volume":"44","author":"K Koga","year":"1994","journal-title":"Pathology international"},{"issue":"1","key":"pone.0283192.ref008","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/0003-4975(91)90478-9","article-title":"Thymoma: results of 241 operated cases","volume":"51","author":"G Maggi","year":"1991","journal-title":"The Annals of thoracic surgery"},{"issue":"4","key":"pone.0283192.ref009","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/0003-4975(95)00669-C","article-title":"Thymoma: a multivariate analysis of factors predicting survival","volume":"60","author":"D Blumberg","year":"1995","journal-title":"The Annals of thoracic surgery"},{"issue":"11","key":"pone.0283192.ref010","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1200\/JCO.1988.6.11.1722","article-title":"Invasive thymoma: the role of mediastinal irradiation following complete or incomplete surgical resection","volume":"6","author":"WJ Curran","year":"1988","journal-title":"Journal of clinical oncology: official journal of the American Society of Clinical Oncology"},{"issue":"2","key":"pone.0283192.ref011","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s00066-014-0740-z","article-title":"Postoperative radiotherapy of patients with thymic epithelial tumors (TET): a retrospective analysis of outcome and toxicity.","volume":"191","author":"MF H\u00e4fner","year":"2015","journal-title":"Strahlentherapie und Onkologie: Organ der Deutschen Rontgengesellschaft"},{"issue":"11","key":"pone.0283192.ref012","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1200\/JCO.1988.6.11.1722","article-title":"Invasive thymoma: the role of mediastinal irradiation following complete or incomplete surgical resection","volume":"6","author":"W Curran","year":"1988","journal-title":"Journal of clinical oncology: official journal of the American Society of Clinical Oncology"},{"issue":"2","key":"pone.0283192.ref013","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/0167-8140(91)90078-U","article-title":"Post-operative radiotherapy in invasive thymoma","volume":"21","author":"MA Jackson","year":"1991","journal-title":"Radiotherapy and oncology: journal of the European Society for Therapeutic Radiology and Oncology"},{"issue":"23","key":"pone.0283192.ref014","doi-asserted-by":"crossref","first-page":"5413","DOI":"10.1002\/cncr.24618","article-title":"Postoperative radiation therapy after complete resection of thymoma has little impact on survival","volume":"115","author":"T Utsumi","year":"2009","journal-title":"Cancer"},{"issue":"5","key":"pone.0283192.ref015","first-page":"1400","article-title":"Role of adjuvant radiotherapy for stage II thymoma after complete tumor resection. 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surgery"},{"issue":"5","key":"pone.0283192.ref028","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1016\/j.athoracsur.2008.11.022","article-title":"Adjuvant radiotherapy for thymic epithelial tumors: a systematic review and meta-analysis","volume":"87","author":"R Korst","year":"2009","journal-title":"The Annals of thoracic surgery"},{"issue":"5","key":"pone.0283192.ref029","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1080\/09553002.2018.1454618","article-title":"Clinical characteristics, risk factors, and outcomes after adjuvant radiotherapy for patients with thymoma in the United States: analysis of the Surveillance, Epidemiology, and End Results (SEER) Registry (1988\u20132013).","volume":"94","author":"H Mou","year":"2018","journal-title":"International journal of radiation biology"},{"issue":"1","key":"pone.0283192.ref030","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/JTO.0b013e318276241c","article-title":"Thymoma: a population-based study 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physics."},{"issue":"1","key":"pone.0283192.ref035","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jtcvs.2015.08.034","article-title":"Multimodality therapy for locally advanced thymomas: A propensity score-matched cohort study from the European Society of Thoracic Surgeons Database.","volume":"151","author":"G Leuzzi","year":"2016","journal-title":"The Journal of thoracic and cardiovascular surgery"},{"key":"pone.0283192.ref036","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.ijsu.2018.04.018","article-title":"The role of postoperative radiation therapy for completely resected stage III thymoma and effect of higher heart radiation dose on risk of cardiovascular disease: A retrospective cohort study.","volume":"53","author":"J Liao","year":"2018","journal-title":"International journal of surgery (London, England)"},{"key":"pone.0283192.ref037","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1186\/1748-717X-8-199","article-title":"Postoperative radiotherapy for completely resected Masaoka stage III thymoma: a retrospective study of 65 cases from a single institution","volume":"8","author":"C Fan","year":"2013","journal-title":"Radiation oncology (London, England)."},{"issue":"1","key":"pone.0283192.ref038","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.athoracsur.2015.06.034","article-title":"The Effectiveness of Postoperative Radiotherapy in Patients With Completely Resected Thymoma: A Meta-Analysis","volume":"101","author":"D Zhou","year":"2016","journal-title":"The Annals of thoracic surgery"},{"issue":"5","key":"pone.0283192.ref039","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1016\/j.ijrobp.2016.01.007","article-title":"Survival Impact of Adjuvant Radiation Therapy in Masaoka Stage II to IV Thymomas: A Systematic Review and 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