Tumours of the thymus: A review of 88 operation cases

Th, Sellors; Ac, Thackray; Ad, Thomson

doi:10.1136/thx.22.3.193

Cited by 74 publications

(15 citation statements)

References 5 publications

(9 reference statements)

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“…In this study 19% or predominantly lymphocytic thymomas were regarded as malignant (based on macroscopic invasion) while the corresponding figure was 56% for epithelial and mixed cell types of thymomas. The better prognosis for predominantly lymphocytic thymomas found in this series is in accord with many reports [8,9,10,15,23,25,26,271, although in some series no such between histologic features and gross invasion has been found [4,28].…”

Section: Discussionsupporting

confidence: 91%

Treatment and prognosis of thymoma: A review of 25 cases

Appelqvist

Kostiainen

Franssila

et al. 1982

Journal of Surgical Oncology

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Experience of 25 patients with thymoma is reported. Based on the presence or absence of gross invasion 17 tumors were regarded as benign, 8 as malignant. All patients were operated on. Twenty-two had a complete excision, 2 a palliative excision, and 1 a biopsy only. Five patients received post-operative radiotherapy and 2 patients were given cytotoxic chemotherapy. None of the 17 patients with a benign thymoma had a recurrence or death due to thymoma during the follow-up. The five- and ten-year survival rates for malignant thymoma were 50% and 17%, respectively. Excision is the treatment of choice for all thymomas, since the prognosis for benign tumor is excellent and the malignancy can only by determined at exploration. Post-operative radiotherapy seems to be indicated in malignant thymoma. Myasthenia gravis and histologic features of thymoma have some value in predicting prognosis.

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Section: Discussionsupporting

confidence: 91%

Treatment and prognosis of thymoma: A review of 25 cases

Appelqvist

Kostiainen

Franssila

et al. 1982

Journal of Surgical Oncology

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“…Radioresponse of thymomas in such an early, short observation period has not been well documented because most of the thymomas have been managed by surgery alone or surgery followed by RT. Historically, a rapid response of thymomas treated by preoperative RT was first documented by Sellors et al (6), but the TR, RT dose, and period between RT and operation were not specified in their report. Urgesi et al reported on 3 thymoma patients treated by preoperative RT of 30 Gy (7); 2 patients achieved a PR and underwent subtotal resection, and the remaining patient achieved a CR, which, however, was not confirmed surgically.…”

Section: Discussionmentioning

confidence: 97%

Radioresponse of Thymomas Verified with Histologic Response

et al. 1998

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Patterns of radiologic response of 10 thymomas treated by preoperative radiotherapy (RT) (18-20 Gy/2 weeks) were determined in conjunction with histologic response. Changes in tumor volume were evaluated with CT scans obtained 5 to 36 days before and 14 to 24 days after the initiation of RT and before surgery. The extent of tumor volume reduction (TR) varied widely (40-78%), while the mean daily volume decrement expressed as a percentage of the pre-RT tumor volume correlated significantly with the pre-RT tumor volume. Histologically, the tumors, all of which were resected 17 to 33 days after RT initiation, generally consisted of predominant fibrous tissues, rare necrotic foci, and few epithelial cells. The TR did not correlate with pre-RT tumor volume, observation period, histologic subtype, or quantity of remaining epithelial cells. The TR of thymomas does not predict RT impact on tumor cells but does reflect the quantity of inherent tumor stroma.

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“…Several studies with a small number of patients receiving preoperative radiotherapy for the presence of extensive disease showed a reduction of the diameter of the tumour confirmed at the time of surgery; the response rate was as high as 80% and a potential reduction of tumour seeding during surgery was also postulated [13,18,[132][133][134]. Currently, the role of preoperative and primary radiation therapy has generally fallen out of interest.…”

Section: Radiotherapymentioning

confidence: 94%

Thymoma and thymic carcinoma

Venuta

Anile

Diso

et al. 2010

European Journal of Cardio-Thoracic Surgery

183

152

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Thymoma and thymic carcinoma are an extremely heterogeneous group of neoplastic lesions with an exceedingly wide spectrum of morphologic appearances. They show different presentations with a variable and unpredictable evolution ranging from an indolent non-invasive attitude to a highly infiltrative and metastasising one. Prognosis can be predicted on the basis of a number of variables, mainly staging, the WHO histological pattern and diameter of the tumour. Complete surgical resection is certainly the gold standard to achieve cure. However, especially in patients with lesions at advanced stage, complete resection may be difficult and recurrence often occurs; at these stages, disease-free long-term survival may be difficult to be accomplished. Chemo- and radiotherapy protocols have been designed to complete surgical treatment and improve results in inoperable patients as well, based on the reported sensitivity of thymic tumours to these treatment modalities. The integration of clinical staging and histology, with the new histogenetic morphological classification, has contributed to design multimodality treatment protocols that help to improve prognosis. Induction therapy can now be applied before surgery in patients with tumours considered inoperable, improving resectability and outcome without adding morbidity and mortality to the surgical procedure. This newly developed approach helps to reduce the recurrence rate and to ameliorate disease-free survival. New therapies are now being evaluated as for many other tumours; however, they still need confirmation in prospective randomised studies. In the future, integrated treatment modality should be incorporated in a standardised approach that goes from a careful assessment of histology, staging and lymph node status, and a constructive and non-empirical co-operation between medical and radiation oncologists, pathologists and thoracic surgeons.

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Tumours of the thymus: A review of 88 operation cases

Abstract: Eighty-eight cases of thymoma are discussed with the object of trying to co-ordinate the histological and clinical features. The pathological specimens were in all cases obtained at operation. The pathology classification introduced by Thomson

Cited by 74 publications

References 5 publications

Treatment and prognosis of thymoma: A review of 25 cases

Treatment and prognosis of thymoma: A review of 25 cases

Radioresponse of Thymomas Verified with Histologic Response

Thymoma and thymic carcinoma

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