Abstract
The standard treatment for thymoma patients with postoperative recurrence has not been established, and the results of intervention remain unclear. We herein performed a retrospective analysis to clarify the outcome. Out of 190 thymoma patients who underwent surgical resection in our institute between 1991 and 2008, 25 patients (13.2%) with postoperative recurrence were investigated. According to WHO classification 2004, 2 cases were pathologically diagnosed as type AB, 2 cases as type B1, 9 cases as type B2, and 12 cases as type B3. Clinically, 3 cases were classified as stage I, 2 cases as stage II, 9 cases as stage III, 8 cases as stage IVA, and 3 cases as stage IVB according to Masaoka's staging system. The median disease-free interval was 26.2 months. Initial sites of recurrence were pleural dissemination in 17 cases, local relapse in 6 cases, and pulmonary metastasis in 2 cases. The treatment for recurrent thymoma included 14 cases with surgical resection (20 pleurectomy, 2 local repeat resection, 1 pulmonary metastasectomy, 1 lymph node dissection), 10 cases with systemic chemotherapy, and 4 cases with irradiation. The 3- and 5-year overall survival rates were 86 and 79%, respectively. The 3-year survival rates were 100 and 68% in patients with surgical and non-surgical treatment, respectively (p=0.06). In conclusion, pleural dissemination was a major relapse pattern following thymoma resection, and prolonged survival could be expected in patients with operative indications.
