Is thymomectomy sufficient for non-myasthenic early stage thymoma patients? A retrospective, single center experience.

BACKGROUND: Thymic complete resection is considered the standard treatment for all thymic tumors; however, the ideal resection for non-myasthenic early stage thymic tumors has not yet been determined. We conducted a retrospective study to examine this unique scenario.

METHODS: We retrospectively analyzed the data of 118 early stage thymoma patients who underwent thymectomy (TM) or thymomectomy (TMM) with curative intent between January 2003 and December 2013 at our institution. Patients with myasthenia, thymic carcinomas, tumors with undetermined histology, and more advanced stage thymoma patients were excluded. We compared overall survival (OS) and disease-free survival (DFS) according to the extent of thymic resection, tumor staging, and size.

RESULTS: One hundred and eighteen patients were staged as early thymoma. TM was performed in 43 (35.6%) patients and TMM in 75 (64.4%). Forty-nine (65.3%) patients with a tumor ≤ 3 cm underwent TMM, and 9 (20.9%) TM. Twenty-six (34.7%) patients with a tumor > 3 cm underwent TMM, and 34 (79.1%) TM. Seventy-four patients were categorized as stage I: 57 (76%) underwent TMM and 17 (39.5%) TM. Forty-four patients were categorized as stage II: 18 (24%) underwent TMM and 26 (60.5%) TM. There was no statistically significant difference in recurrence between the groups (P = 0.250).

CONCLUSION: No difference in the rate of recurrence was observed in early stage non-myasthenic patients following thymic resection and Masaoka-Koga staging. However, TM is considered a better option for early stage thymoma patients with tumors > 3 cm.