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The Annals of Thoracic Surgery, Vol 51, 152-156, Copyright © 1991 by The Society of Thoracic Surgeons
G Maggi, C Casadio, A Cavallo, R Cianci, M Molinatti and E Ruffini
Clinical and histopathological aspects of 241 thymomas were reviewed. One
hundred sixty of the patients with thymoma had myasthenia gravis and 15 had
other autoimmune diseases; 55% of the thymomas were encapsulated and 45%
invasive. Operation was radical resection in 87.5% of the patients,
subtotal resection with residual tumor in 8.7%, and simple biopsy in 3.7%.
A tumor relapse was observed in 24 patients (10%): 2 (1.5%) of 133 with
encapsulated thymomas and 22 (20.4%) of 108 with invasive thymomas; among
these patients, a relapse was found in 20.6% of the patients who received
radiotherapy postoperatively and in 24.6% who did not. Adverse prognostic
factors were clinical stage IVa (multiple pleural nodes), not feasible
resection (for technical reasons), inoperable tumor relapse, and
association with one of the following autoimmune diseases: pure red cell
aplasia, hypogammaglobulinemia, and lupus erythematosus. Conversely,
myasthenia gravis is now a curable disease; it contributes to early
discovery of associated thymoma, thus allowing a better survival for
patients with thymoma who have myasthenia gravis compared with patients
with thymoma but without myasthenia gravis (p less than 0.05).
Postoperative radiotherapy does not seem necessary after removal of
encapsulated thymomas, but it is advisable in case of invasive thymomas,
regardless of the extent of the resection.
ARTICLES
Thymoma: results of 241 operated cases
Department of Thoracic Surgery, University of Torino, Italy.
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