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Jean-François Regnard
Pierre Magdeleinat
Lionel Guibert
Lorenzo Spaggiari
Philippe Levasseur
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Ann Thorac Surg 1997;64:1593-1598
© 1997 The Society of Thoracic Surgeons

Original Articles: General Thoracic

Results of Re-resection for Recurrent Thymomas

Jean-François Regnard, MD, Franck Zinzindohoue, MD, Pierre Magdeleinat, MD, Lionel Guibert, MD, Lorenzo Spaggiari, MD, Philippe Levasseur, MD

Department of Thoracic and Vascular Surgery, Marie Lannelongue Hospital, Le Plessis Robinson, France

Background. The treatment of recurrent thymomas remains controversial.

Patients. The place for re-resection was retrospectively studied in 28 consecutive patients operated on during the last 40 years. The initial Masaoka staging of the thymoma was stage I, 4; stage II, 8; stage III, 11; and stage IVa, 3. Postoperatively, 14 have had radiation therapy, 1 chemotherapy, and 13 no adjuvant treatment. Seven patients had development of recurrences, 15 had pleuropulmonary metastases, 5 had both, and 1 had thoracotomy scar recurrence. Nineteen patients had a complete resection and 9 an incomplete one.

Results. Most local recurrences appeared after resection of stage I or II thymomas. On the other hand, in patients with stage III or IV thymomas pleural or pulmonary metastases mainly developed. No local recurrence occurred in patients who initially received postoperative radiation therapy. Five-year and 10-year survival rates were 51% and 43%, respectively, for the overall population. Among the 19 patients with complete resection, only 3 patients had a subsequent recurrence; 1 of them could be reoperated on and is still alive and free of disease.

Conclusions. Thymoma recurrences often appear as a locoregional rather than a hematogenous spread. Re-resection can be recommended in selected patients.


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Discussion
Ann. Thorac. Surg. 1997 64: 1598. [Extract] [Full Text]





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