Management and Outcome of Thymoma: A Retrospective Analysis

ABSTRACT

Thymoma is a rare disease. The treatment of invasive thymoma remains controversial. To evaluate the outcome of thymoma we reviewed aseven years [1996-2002] experience with 26 patients at PGIMER Chandigarh. It constituated about 16% of all mediastinal tumours in our institutions. All the patients had surgical intervention and diagnosis was made on pathologicalstudy. Post-operative staging was made on mordified Masoaka staging system. Out of 26 patients, six were with stage-1, 5 with stage- 2, 7 with stage-3 and 8 with stage 4. The pathological classification included 6 lymphocytic predominant,12 epitheloid and 8 mixed lymphoepitheloid histology. Myasthenia gravis was associated with 12 patients. Ten patients had complete surgical resection, 7 had incomplete surgery and 9 had only biopsy. All thepatients received external beam radiation with doses ranging from 3000 Cgy to 5000 Cgy in 3 to 5 weeks with a fraction size of 180-200 Cgy. Three patients received systemic chemotherapy with multidrug platinum based regimens. The median follow up was 26.2 months. Patients who received adjuvant external radition after complete surgery did better than who had incomplete surgery or only biopsy. Overall five years survival was 56.85. Post operative radiotherapy improved locoregional controls, however clinical stage and type of surgery were the two most important prognostic factors. Role of chemotherapy needs to be further assessed.