Limited thymectomy for stage I or II thymomas

• Published in: Lung cancer (Amsterdam, Netherlands) Vol. 68; no. 3; pp. 460 - 465
• Main Authors: Onuki, Takuya, Ishikawa, Shigemi, Iguchi, Kesato, Goto, Yukinobu, Sakai, Mitsuaki, Inagaki, Masaharu, Yamamoto, Tatsuo, Onizuka, Masataka, Sato, Yukio, Ohara, Kiyoshi, Sakakibara, Yuzuru
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ireland Ltd 01-06-2010; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Disease Progression; Diseases of striated muscles. Neuromuscular diseases; Female; Follow-Up Studies; Hematology, Oncology and Palliative Medicine; Humans; Limited surgery; Male; Masaoka staging; Medical sciences; Middle Aged; Multiple thymoma; Myasthenia gravis; Myasthenia Gravis - etiology; Neoplasm Staging; Neurology; Pneumology; Postoperative; Postoperative Complications; Pulmonary/Respiratory; Retrospective Studies; Survival Analysis; Thymectomy; Thymoma; Thymoma - diagnosis; Thymoma - mortality; Thymoma - pathology; Thymoma - surgery; Thymus Neoplasms - diagnosis; Thymus Neoplasms - mortality; Thymus Neoplasms - pathology; Thymus Neoplasms - surgery; Tumors; Tumors of the respiratory system and mediastinum; WHO histologic classification; Postoperative; Multiple thymoma; Thymectomy; Myasthenia gravis; Thymoma; Masaoka staging; Limited surgery; WHO histologic classification; Mediastinum disease; Thymus pathology; Cancerology; Surgery; Classification; Benign neoplasm; WHO; Pneumology; Nervous system diseases; Neuromuscular diseases; Multiple; Respiratory disease; Histology; Malignant tumor; Treatment; Thymic epithelial tumor; Limit; Cancer
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2009.08.001

Abstract Background Once an anterior mediastinal tumor has been diagnosed as a thymoma, complete excision including the thymic gland and perithymic fat is currently the procedure of choice. However, little is known about the clinical outcome of grossly encapsulated thymomas excised only with the surrounding tissue while leaving a part of the thymic gland. Methods A retrospective historical comparative study was conducted on 79 patients who had received surgery for stage I ( n = 25) or stage II ( n = 54) thymomas. Total thymectomy was performed in 61 patients (Total Thymectomy Group), whereas resection of tumors with only the surrounding tissue was carried out in 18 (Limited Thymectomy Group). The follow-up interval was longer in the Limited Thymectomy Group because these patients were treated longer ago (104.2 ± 58.1 months vs 67.3 ± 54.8 months, p < 0.05). Results One case in the Limited Thymectomy Group showed postoperative myasthenia gravis (5.6%). Two patients with multiple thymomas (2.5%) were treated with total thymectomy. One case in the Limited Thymectomy Group, which had been diagnosed as Masaoka stage II and WHO type B3 at initial surgery, recurred. None died of tumor progression in this study. Disease free survival rates at 10 years did not differ between the Limited Thymectomy and Total Thymectomy Groups (85.7% and 82.0%, respectively). There were no statistical differences in the incidence of postoperative myasthenia gravis and disease free survival between the two groups. Conclusion Resection of thymomas with surrounding tissue instead of total thymectomy can be indicated for stage I or II thymomas in light of disease free and overall survival, post-operative onset of MG, and the incidence of multiple lesions.