Abstract | BACKGROUND: The aim of this study is to evaluate the impact of thymectomy in patients with thymic neoplasms and to identify clinical and histopathological factors associated with improved long-term outcome of surgery. METHODS: We treated 74 patients between February 1987 and July 1993. There were 29 total and 36 simple thymectomies. These last cases, all non-myasthenic, had benign thymomas ( n=30) but 6 had thymic carcinomas. Nine tumors were no-resected (5 thymomas and 4 thymic carcinomas). Minimum follow-up by Department of Thoracic Surgery Istituto Nazionale Tumori was 60 months after thymectomy. We divided the specimens according to Marino and Muller-Hermelink's classification: 54 thymomas, 18 thymic carcinomas and 2 no-diagnosis specify thymomas. There were 53 stage I, 1 stage II, 13 stage III, 5 stage IVa and 2 stage IVb according to Masaoka. RESULTS: Forty-six patients with treated thymoma were alive without disease at the end of follow-up, the remaining 8 died from recurrence in 6, a new tumor in 1 and a heart attack in the last. Of 18 thymic carcinomas 9 were alive at the end of follow-up (1 with recurrence), only 4 dead from recurrence. The actuarial survival of patients with thymomas was 88.5% at 5 years, (73.6% in cortical type, 85.7% in medullary type, 93.9% in mixed type, 100% in predominantly cortical type). Myasthenia gravis didn't influence the survival: 87.3 (no MG) vs 90%. Advanced stage thymomas significantly increased the risk of death from early stage I: 32.4 vs 100% at 5 years. In thymic carcinoma patients with well-differentiated thymic carcinoma (WDTC) died less than others: the actuarial probability of survival at 5 years was 90 vs 68%. CONCLUSIONS:
Thymectomy was the best treatment to long term outcome. In our experience, survival was related to histotype and to local extension of tumor.
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Authors | C Lequaglie, G Giudice, P P Brega Massone, B Conti, I Cataldo |
Journal | The Journal of cardiovascular surgery
(J Cardiovasc Surg (Torino))
Vol. 43
Issue 2
Pg. 269-74
(Apr 2002)
ISSN: 0021-9509 [Print] Italy |
PMID | 11887069
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Myasthenia Gravis
(complications)
- Prognosis
- Risk Factors
- Survival Analysis
- Thymectomy
- Thymoma
(mortality, pathology, surgery)
- Thymus Gland
(pathology)
- Thymus Neoplasms
(mortality, pathology, surgery)
- Time Factors
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