In thymoma with R0 resection showing pure thymoma, how would the presence of slightly elevated preoperative AFP and bHCG influence your approach to adjuvant radiation, if at all?

Would not change my recommendation. R0 stage 1, I would observe; R0 stage II-IV, consider PORT with a more tentative recommendation for stage II if high risk histology, close surgical margins, or pleural adhesions. I think in this situation, it may be wise just to check a post-op AFP and bHCG to see...