Thymectomy for thymoma spanning three decades at Tor Vergata thoracic surgery center

Abstract

Background: Thymoma is most common primary neoplasm of the anterior mediastinum in the adult population. Surgery remains the cornerstone of the treatment. Methods: In a three decades period [1986–2015] we performed a total of 225 patients for thymoma through open (n=182) or minimally invasive access (n=43) achieving 189 complete resections. Data were reviewed and main prognostic factors considered by Kaplan-Meier and log rank methods. Results: Completeness of resection, Masaoka stage, WHO histology, cell cycle protein expression and preoperative neutrophil to lymphocytes ratio were significant prognosticators. Whereas concomitant myasthenia gravis (MG) and surgical approach were not. Recurrences are slow-growing and deserves always aggressive treatment. Conclusions: Despite the bias due to the long time-span, our analysis allows the evaluation of the whole aspects of this surgery and results are in accordance with those already reported in the literature. New prognostic factors such as cell cycle proteins expression and preoperative neutrophil to lymphocytes ratio resulted significant.