A total of 22 studies met the inclusion criteria, but only 13 reported sufficient data be included in the meta-analysis (n=592). Of these 592, 342 patients received complete resection alone and 250 received complete resection plus adjuvant radiotherapy. Quality scores ranged from 0 to 14; three of the four highest ranked studies reported exclusively on stage II patients. Significant statistical heterogeneity was noted only for the stage III analysis and a random-effects model was used.
The pooled odds ratios that comparing complete resection with complete resection plus adjuvant radiotherapy in all thymic epithelial tumours stage II and III patients indicated there was no significant difference in rate of recurrence (OR 1.05, 95% CI 0.63 to 1.75, p=0.840). Analysis by stage did not significantly alter this result.
Ten studies compared survival rates for complete resection and reported the data according to stage, but meta-analysis was not possible due to poor reporting of the primary data. Eight of these 10 studies reported no difference between groups, one found a significant increase in survival for those patients receiving adjuvant radiotherapy and one reported significant benefit for the complete resection within radiotherapy patients.
The test for publication bias was not statistically significant (p=0.669).