Thymoma-clinical disorders and results of surgical treatment
Fijimura, S.; Kondo, T.; Yamauchi, A.; Handa, M.; Okabe, T.; Shinozaki, F.; Hashimoto, K.; Nakada, T.
Nihon Kyobu Geka Gakkai 29(11): 1707-1714
1981
ISSN/ISBN: 0369-4739 PMID: 7341693 Document Number: 169724
Forty-eight patients with thymoma 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, 1 aplastic anemia and 1 hypogammaglobulinemia. Five patients out of 6 died within 2 yr after surgery, suggesting poor prognosis of thymoma with associated diseases. Thymomas were divided into 2 categories on the basis of surgical and gross findings, i.e., encapsulated and invasive. The latter showed significant decrease in H concentrations and A/G ratio preoperatively as compared with those in the former. Total resection of the tumor was performed in all the patients with encapsulated thymoma, while only 6 of 27 with invasive thymoma underwent total tumor resection. Eleven patients with invasive thymoma underwent combined resection of adjacent tissues. Histologic examinations showed an increased frequency of epithelial type in invasive thymoma. In encapsulated thymomas 4 patients died as a result of non-tumor causes within 10 yr after surgery; with a 5-yr survival of 73.3% and a 10-yr survival of 63.6%. Invasive thymomas have a 22.7% 5-yr survival and a 10.5% 10-yr survival. In the patients who underwent concomitant resection of adjacent tissues of invasive thymomas, a 5-yr survival was 42.8% and a 10-yr survival was 33.3%. Fourteen of 27 patients with invasive thymomas showed gross implants and/or metastasis from the tumor. Two of 14 metastatic thymoma are surviving > 10 yr postoperatively. 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 is emphasized.