Resection of thymoma should include nodal sampling

Abstract

Nodal status seems to be an important prognostic factor in patients with thymoma. Until the prognostic significance of nodal metastases is better understood, surgical therapy for thymoma should include sampling of regional lymph nodes.

Impact of Lymph Node Dissection on Thymic Malignancies: Multi-Institutional Propensity Score Matched Analysis

“…However, studies from the United States have reported high lymphatic spread rate: 13.3% of 440 thymomas from the Surveillance, Epidemiology, and End Results program database. 8 The difference in metastatic rate might be due to differences in inclusion criteria. The study using the Surveillance, Epidemiology, and End Results database included only patients who had at least one lymph node analyzed pathologically.…”

“…The study using the Surveillance, Epidemiology, and End Results database included only patients who had at least one lymph node analyzed pathologically. 8 This might have included patients who underwent LND. Our data also clearly showed that LND increased the lymph node metastasis rate.…”

“…In previous studies, it was difficult to determine more significant predictor of lymph node metastasis between the extension of tumor invasion and tumor size. [6][7][8][9] Higher lymph node metastasis rates in larger tumors irrespective of stages suggest that Figure 2. Freedom from recurrence curve on thymic malignancies.…”

“…Similar to many other studies, our study showed that lymph node metastasis was a significant adverse prognostic factor in thymic malignancies. 6,[15][16][17][18][19][20] Weksler et al 8 have shown that the presence of nodal metastases increases the risk of death by approximately three-fold. In our study, the presence of lymph node metastasis was accompanied by a significantly worse FFR.…”

Video-assisted and minimally-invasive open chest surgery for the treatment of mediastinal tumors and masses

“…This has certainly been the experience of the senior author of this review. More recent data from the SEER database (20) have shown, however, that as much as 15% of patients may have lymph node involvement and that all patients undergoing thymectomy for TETs should have routine sampling or even dissection of lymph nodes, especially of the nodes located in the anterior mediastinum (17,20).…”