PURPOSE: Even after complete resection, recurrence of thymoma is not infrequently observed. We analyzed re-operated thymoma cases focusing on the clinical features.
METHODS: A total of 115 patients with thymoma had surgical resection between 1985 and 2007 in our institution, and 7 patients with recurrent thymoma underwent re-operation. We clinically reviewed the recurrent cases, and investigated the causes of the relapse.
RESULTS: There were 5 males and 2 females with a mean age of 61 years. Primary tumors had been completely removed in the first operation, and were classified as stage I in 1 patient, stage II in 3, stage IVa in 2, and unknown stage in 1 according to the Masaoka classification. Histologic types of those tumors were AB in 2 patients, B2 in 3 patients and B3 in 2 patients according to the WHO pathological classification. The recurrent tumors were found to be local recurrence in 4 patients, pleural dissemination in 2, and lymph node metastasis in 1. Complete re-excision was possible in 6 patients, and all the 7 patients have survived. In patients with local recurrence, 3 had undergone enucleation of the primary tumor or incomplete thymectomy in the first operation. On the other hand, no local recurrence was observed in 90 patients who had had total thymectomy. There was a significant difference of local recurrence rate between patients with or without total thymectomy in the primary operation.
CONCLUSION: To avoid local recurrence, enucleation of the tumor or incomplete thymectomy should be abandoned. We recommend total thymectomy in the primary operation for thymoma.
CLINICAL IMPLICATIONS: Thymoma after complete resection is rarely recurred in mediastinum, pleura, or lung. Because one of the causes of recurrence was considered the extent of resection, total thymectomy should be recommened in the primary operation for thymoma.
DISCLOSURE: Norihisa Ohata, No Financial Disclosure Information; No Product/Research Disclosure Information