Recurrence of thymoma: Clinicopathological features, re‐operation, and outcome

Abstract

Our study showed that re-operation should not be attempted for all patients with recurrent thymoma. Because effect of subtotal resection for severe pleural recurrence is disappointing, total resection for minimal pleural dissemination or small local recurrence will be undertaken to improve postrecurrent survival. Careful follow-up for > 10 years will increase the chance of the total resection of the recurrent thymoma.

Long-Term Outcomes of Recurrent Thymoma

“…Whereas, unlike the previous studies [3,4,[6][7][8]12,[16][17][18][19][20][21], we observed that much high percent (71.4%) of patients who underwent reoperation received adjuvant chemotherapy, radiotherapy, or chemoradiotherapy, which may improve the treatment outcomes of recurrent thymoma and confound the benefit of reoperation. Based on that adjuvant treatment can improve the outcomes of patients who have median survival interval after recurrence of the chemotherapy group was higher compared with the group of patients without retreatment, but no statistical significance (P=0.062).…”

“…The answer probably is no. It was reported that the 5-year OS rates after initial treatment of complete resection were much better than incomplete resection for patients with recurrent thymoma (64% to 91.7% vs. 16% to 81.6%) [6,7,16,17], and complete resection even resulted in comparative survival with patients without recurrence [16], however, incomplete resection had no survival benefit and the prognosis was poor [6,12,16,17]. In addition, lung recurrences may be operated if they appear to be completely operable, which may achieve long-term survival [22].…”

“…Owing to the low morbidity of thymoma, the lower incidence of recurrence, various recurrence patterns, retrospective single institute nature of studies, and the selective bias of studies, the optimal strategy for managing recurrent thymoma remains controversial. Most of authors have recommended reoperation for recurrent thymoma based on improved survival compared to non-operated patients [4][5][6][7][8][9][10], whereas a few have discouraged reoperation because of the high perioperative morbidity [4,11,12]. We reviewed retrospectively the outcomes and prognostic factors of 32 patients that relapsed after radical resection to try to bolster strategies for the treatment and surveillance of recurrent thymoma.…”

Comparison of patterns of relapse in thymic carcinoma and thymoma

“…With our latest recurrence occurring at 95 months, we concur with others in advocating prolonged, if not lifelong follow-up. [14,29] In conclusion, thymic carcinoma is a distinct entity from thymoma, and as a more aggressive tumor, has a higher propensity for distant spread, early relapse, and lower overall and progression-free survival. Our results reiterate the importance of complete resection and the need for accurate pathological diagnosis and vigilant surveillance post-therapy.…”

“…[12] As with previous observations, pleural (locoregional) metastases appear to be most common mode of recurrence in thymoma. [10,[12][13][14][15] Other extrathoracic sites in thymoma have been reported in the literature, including 3 patients who had brain and liver metastases. [1,16] The one thymoma patient with a lung metastasis originally presented with what is considered a low-grade histologic subtype (WHO A), serving as a cautionary tale that no patient with a thymic tumor is immune from the potential for distant spread.…”