[Surgical therapy for elderly patients with mediastinal neoplasms except for thymic epithelial tumors]

Surgical treatment for old patients with mediastinal neoplasms except for those of thymic epithelial origin was retrospectively reviewed. Ten (7.5%) out of 133 patients who had underwent surgical therapy for extrathymic mediastinal tumors in our institute were no younger than 70. Two of them had malignant neoplasms (a germ cell tumor and a malignant fibrous histiocytoma). One (0.75%) 76-year-old patient with a thymic cyst had died of the pulmonary thromboembolism on the 3rd postoperative day. A 76-year-old patient with a malignant germ cell tumor had undergone reexploration because of persistent air leakage from the bronchopleural fistula. Surgical procedures were practically performed to determine the pathological diagnosis or to treat the patients with pathologically benign neoplasms because of diverse biological behaviors of these mediastinal tumors. In conclusion, surgical indications of the extrathymic mediastinal neoplasms should be more strictly limited and less invasive surgery should be applied to older patients as far as possible.