Thymoma-clinical disorders and results of surgical treatment

S. Fijimura, T. Kondo, A. Yamauchi, M. Handa, T. Okabe, F. Shinozaki, K. Hashimoto, T. Nakada

Research output: Contribution to journalArticlepeer-review

Abstract

48 patients with thymoma experienced during the past 16 year in our department were studied in terms of associated syndromes, preoperative hematologic and immunologic findings, operative observations, microscopic pathology and prognosis. Associated syndromes were found in 6 patients, including 4 myasthenia gravis, one aplastic anemia and one hypogammaglobulinemia. Five patients out of 6 died within 2 years after surgery, suggesting poor prognosis of thymoma with associated diseases. Thymomas were divided into two categories on the basis of surgical and gross findings, i.e., encapsulated and invasive. The latter showed significant decrease in hemoglobin concentrations and A/G ratio preoperatively as compared with those in the former, indicating more influence to the hematologic and immunologic systems of those patients. Total resection of the tumor was performed in all the patient with encapsulated thymoma, while only 6 of 27 with invasive thymoma underwent total tumor resection. 11 patients with invasive thymoma underwent combined resection of adjacent tissues of the tumor during operation. Histologic examinations of thymomas in our series showed an increased frequency of epithelial type in invasive thymoma rather than in encapsulated thymoma. In encapsulated thymomas, 4 patients died not as a result of tumor within 10 years after surgery. In encapsulated thymomas, there is a 5-year survival of 73.3% and a 10-year survival of 63.6%. Invasive thymomas have a 22.7% 5-year survival and a 10.5% 10-year survival. In the patients who underwent concomitant resection of adjacent tissues of invasive thymomas, 5-year survival was 42.8% and 10-year survival was 33.3%. 14 of 27 patients with invasive thynomas showed gross implants and/or metastasis from the tumor. However, 2 of 14 cases of metastatic thymoma are surviving more than 10 years postoperatively. Our results emphasize the benefit of attempted total surgical extirpation whenever possible in the presence of obviously invasive thymomas, and the indication of postoperative radiation, as well as chemotherapy with anticancer agents.

Original languageEnglish
Pages (from-to)1707-1714
Number of pages8
JournalJournal of the Japanese Association for Thoracic Surgery
Volume29
Issue number11
Publication statusPublished - 1981 Dec 1

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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