[Long-term survival of surgically treated lympho-epithelial thymomas]

The authors report the results of a multi-centre trial on 500 cases of lymph-epithelial thymoma (TLE) treated by 14 surgical teams. Most typically a tumour of the adult in the fifth decade, occurring most commonly in women (60%), one in every two cases of TLE occurs in auto-immune disease: usually myasthenia. Most often (3 times out of 4) the disease is latent and occupies the middle (40%) or superior mediastinum (30%). In 15% of cases the pulmonary radiograph is normal. Radical surgery is possible in 75% of cases, otherwise it is incomplete or even reduced to a simple biopsy. The 15 year prognosis obtained using actuarial survival curves is based on the surgical-anatomical classification of the study group of thymic tumours (GETT) giving: for stage I: a survival of 80% for stage II to IVA of 40% and for stages III to IVB of around 10%. Finally it should be noted that existence of a recurrence after a complete surgical excision (stage I) poses the problem of post-operative radiotherapy and the associated total thymectomy. Also, the identical prognosis after biopsy or incomplete surgery (IIIA and IIIB) with an increased morbidity for incomplete surgery. Finally the confirmation that pleural involvement (IVA) is not as adverse a factor as one would have supposed.