Long-Term Outcomes of Thymoma Treated at a Single Institute

Thymomas are uncommon tumors that originate from epithelial cells of thymus and may have varying clinical course.

A retrospective review of medical records of thymoma patients treated between January 2012 and April 2022 at our institute was conducted.

There were a total of 23 patients (12 males and 11 females) with median age of 52 years (range, 33-77 years). Eleven patients (47.8%) had associated paraneoplastic syndromes of which 10 (43.5%) had myasthenia gravis and 1 (4.3%) had pure red cell aplasia. Average maximal tumor diameter was 62 mm (28-160 mm). Masaoka-Koga stage distribution was as follows: stage I ( n  = 2, 8.7%), IIA ( n  = 4, 17.4%), IIB ( n  = 1, 4.3%), IIIA ( n  = 2, 8.7%), IIIB ( n  = 4, 17.4%), IVA ( n  = 7, 30.4%), and IVB ( n  = 3, 13.1%). The World Health Organization type B2 was the commonest histology ( n  = 12, 52.17%), followed by B3 ( n =7, 30.4%), B1 ( n  = 2, 8.7%), AB ( n  = 1,4.3%), and A ( n  = 1, 4.3%). Six patients received neoadjuvant chemotherapy with cyclophosphamide regimen, 22 (95.6%) underwent surgery, and 1 patient received adjuvant chemotherapy. R0 resection was attained in 20 (91%) patients, R1 resection in 1 (4.5%) patient, and R2 in 1 (4.5%) patient. All operated patients underwent postoperative radiotherapy (45-60 Gy in 25-30 fractions). Four patients relapsed at a median duration of 14 months (2-26 months). At a median follow-up of 6 years, 5-year overall survival was 67.1% and 5-year progression-free survival was 66.6%. Local control at 5 years was 86.6%.

Despite majority of our patients presenting at an advanced stage, the local control rates are encouraging and reinforce multimodality approach.