TREATMENT FOR THYMOMAS

Abstract

Surgical treatment for thymoma is studied by analyzing causes of postoperative recurrences and deaths by stages in 76 patients operated on for thymomas, consisting of 21 in stage I and 55 in stage II, III and IVa. Of the 76 patients, 41 had myasthenia gravis (MG) and 26 received irradiation. Recurrence of the tumor occurred in 4 patients in stage II, 2 of which associated with MG. Of the 4 patients, thymomectomy was carried out in one without postoperative irradiation, and total resection including normal thymus tissues (complete resection) in the remained 3 patients. Death after surgical treatment occurred in 10 patients, one in stage II, 7 in stage III, and 2 in stage IVa, each five of whom underwent complete resection and incomplete resection respectively with irradiation in each 2 of the 5. Causes of the deaths included tumors in 4 patients, MG in 4 and postoperative complications in 2. These findings have suggested that stage I tumors may be treated with thymomectomy or complete resection with or without postoperative radiotherapy; stage II or more advanced tumors, especially those associated with MG, should be treated with complete resection as well as radiotherapy, where the tumor must be resected as complete as possible; and radiotherapy is effective for stage III and IVa tumors.