Surgical management of locoregionally recurrent thymoma

There is no standard treatment for recurrent thymoma, but treatment is usually palliative therapy. For this article, we retrospectively reviewed our experiences to examine the efficacy of surgical treatment and the extent of adequate resection.

From 1997 to 2007, 15 patients underwent surgical resection for locoregional recurrence of thymoma in the Samsung Medical Center. The tumors at the initial resection were B1 in two patients, B2 in six, B3 in three and C in four according to the World Health Organization histological classification. Complete resection was achieved in 12 patients with pleurectomy (n = 11) or extrapleural pneumonectomy (n = 1).

There was neither perioperative mortality nor significant immediate postoperative morbidity. After discharge, chest computed tomography scans were evaluated after a minimum of 6 months and the median follow-up duration was 45 months. At the time of writing, 10 patients had survived with (n = 5) or without (n = 5) rerecurrence (3-year survival = 84.0%). Survival was significantly superior in patients with complete resection compared with those with incomplete resection (P= 0.008).

Surgical resection could be considered in patients with locoregionally recurrent thymoma because it can be performed safely and offers a chance of long-term survival to some patients. To achieve complete resection, more extended surgery must be considered for multiple pleural metastases.