- Volume 17 Issue 2
Thymic tumors are the most common tumors in the anterior mediastinum. Total resection is the main treatment and predictor of longer survival. Adjuvant radiotherapy alone or in combination with chemotherapy is recommended with incomplete excision or advanced disease. Thirty seven patients with thymic tumors were included in this retrospective study from January 2001 till December 2012. They were studied regarding age, sex, performance status, tumor size and invasion, stage, pathology, treatment given, overall and progression free survival. Myasthenia gravis was present in 18.1% of the patients. Masaoka stage III was diagnosed in 40.5% of the cases followed by stage II in 24.3% and the other stages with lower percentages. Pathology type B3 was the most frequent followed by B2 and B1 with percentages of 27, 24.3 and 21.7 respectively. Complete resection was conducted in 11 cases (29.75%). Partial resection or debulking was done in 15 (40.5%) and a biopsy was taken in 11 cases (29.8%) Adjuvant chemotherapy was given to 14 patients (37.8%) and neoadjuvant to 13 (35.2%). Adjuvant radiotherapy was given to 17 patients (46%) and neoadjuvant to 14 (37.8%). The 5-year overall survival by was 83% for stage I, 71% for stage II, 60% for stage III, and 44% for stage IV (p=0.0426). Five year progression free survival was 71% for stage I, 62% stage II, 42% stage III, and 37% for stage IV (p=0.0532). In conclusion with the rare thymic tumors early stage and complete resection have the highest impact on overall and progression free survival.
- Chung D (2000). Thymic carcinoma-analysis of nineteen clinicopathological studies. Thorac Cardiovasc Surg, 48, 114-119. https://doi.org/10.1055/s-2000-9868
- Detterbeck FC, Parsons AM (2011). Management of stage I and II thymoma. Thorac surg Clin, 21, 59-67. https://doi.org/10.1016/j.thorsurg.2010.08.001
- Detterbeck FC, Zeeshan A (2013). Thymoma: current diagnosis and treatment. Chin Med J Engl, 126, 2186-91.
- Engels EA, Pfeiffer RM (2003). Malignant thymoma in the United States demographic patterns in incidence and associations with subsequent malignancies. Int J Cancer, 105, 546-51. https://doi.org/10.1002/ijc.11099
- Kondo K, Monden Y (2003). Therapy for thymic epithelial tumors: a clinical study of 1320 patients from Japan. Ann Thorac Surg, 76, 878-84. https://doi.org/10.1016/S0003-4975(03)00555-1
- Lopez-Cano M, Ponseti-Bosch JM, Espin-Basany E, et al (2003). Clinical and pathologic predictors of outcome in Thymoma-Associated myasthenia gravis. Ann Thoracic Surgery, 76, 1643-9. https://doi.org/10.1016/S0003-4975(03)01139-1
- Usman A, Xiaopan Y, Frank D et al (2015). Thymic carcinoma outcomes and prognosis: Results of an international analysis. J Thorac Cardiovasc Surg, 149, 95-101. https://doi.org/10.1016/j.jtcvs.2014.09.124
- Venuta F, Anile M, Diso D, et al (2010). Thymoma and thymic carcinoma. Eur J Cardiothorac Surg, 37, 13-25. https://doi.org/10.1016/j.ejcts.2009.05.038
- Weksler B, Dhupar R, Parikh V, et al (2013). Thymic carcinoma:a multivariate analysis of factors predictive of survival in 290 patients. Ann Thorac Surg, 95, 299-303. https://doi.org/10.1016/j.athoracsur.2012.09.006