European Journal of Cardio-Thoracic Surgery, Vol 6, 180-187, Copyright © 1992 by European Association for Cardio-thoracic Surgery
Treatment of thymomas. A report of 67 cases
P Fuentes, E Leude, C Ruiz, L Bordigoni, P Thomas, R Giudicelli, JA Gastaud and N Morati
Department of Thoracic Surgery, Sainte-Marguerite Hospital, Marseille, France.
From 1979 to 1989, 126 patients were treated for thymic tumors. Of these,
67 (53%) had thymomas occurring in 27 men and 40 women; the mean age was 46
years: 24 patients had no symptoms and myasthenia gravis was present in 21
cases. A complete resection was performed in 45 patients, associated in 22
with postoperative adjuvant treatment (radiotherapy, 2; radio- and
chemotherapy, 20). Two patients had a partial resection followed by
radiotherapy and chemotherapy. Twenty patients had initially only a biopsy
and were treated by irradiation in 3 cases, radio- plus chemotherapy in 16,
radio- plus chemotherapy and subsequent resection in 1 case. The staging
was carried out according to the GETT Classification (stage I A:26; I B:6;
II:12; III A:1; III B:18; IVA:4). Thymomas were found to be of predominant
epithelial type in 12 cases, predominantly lymphocytic type in 9, and mixed
in 46. No recurrence occurred after complete resection. The overall 10-year
survival was 71.1%. A good correlation was found according to staging: 96%
in stage I; 80% in stage II; 35% in stage III. Presence of myasthenia
gravis did not affect the results. The best prognostic factor remains
complete resection with postoperative radiotherapy to prevent recurrences.
The role of adjuvant chemotherapy needs further evaluation.
