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General Thoracic and Cardiovascular Surgery
Published in: General Thoracic and Cardiovascular Surgery 4/2020

01-04-2020 | Thymoma | Original Article

Surgical treatment of single and multiple thymoma recurrences

Authors: Angelo Carretta, Paola Ciriaco, Piergiorgio Muriana, Alessandro Bandiera, Giampiero Negri

Published in: General Thoracic and Cardiovascular Surgery | Issue 4/2020

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Abstract

Objectives

A significant number of patients with thymoma develop a recurrence after surgery. The results of previous studies analyzing therapeutic strategies in the treatment of recurrences have been controversial. Aim of the study was to evaluate the role of surgery in the treatment of thymoma recurrences assessing prognostic factors related with survival.

Methods

Between January 1993 and September 2018, 27 of 161 patients had a recurrence after complete thymoma resection. Twenty-one (13%) underwent surgical treatment of the recurrence. Primary tumor stage was: I in a patient, IIa in five, IIb in nine and III in six. The recurrence was regional in all patients and both regional and distant in four. WHO histological classification was: A in two patients, B1 in two, B2 in seven and B3 in 10 patients.

Results

Median disease-free survival from surgical treatment of the primary tumor and recurrence was 44 months (1–124). Thirty-eight operations were performed (range 1–5). Complete resection rate was 66%. Adjuvant radiotherapy and chemotherapy after surgical treatment of recurrences were performed respectively in ten and nine patients, including eight patients with multiple recurrences. Five and 10-year tumor-specific survival from recurrence was, respectively, 79% and 66%. Survival analysis showed a significant correlation between survival and WHO classification, with a significantly lower survival in patients with B3 tumors in comparison with A to B2 tumors (p = 0.026).

Conclusions

Long-term survival was observed following surgical treatment of thymoma recurrences. These results were observed even after multiple recurrences when surgical treatment was performed within a multimodality oncological approach.
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Metadata
Title
Surgical treatment of single and multiple thymoma recurrences
Authors
Angelo Carretta
Paola Ciriaco
Piergiorgio Muriana
Alessandro Bandiera
Giampiero Negri
Publication date
01-04-2020
Publisher
Springer Singapore
Published in
General Thoracic and Cardiovascular Surgery / Issue 4/2020
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-019-01229-w

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