Management of invasive thymoma at Groote Schuur Hospital, Cape Town.
Fifteen patients (median age 55 years; range 23-69 years) with macroscopic invasive thymoma or thymic carcinoma were treated at Groote Schuur Hospital between 1969 and 1988. Stage 3 (macroscopically invasive) disease was present in 12 patients (80%) and stage 4 (metastatic disease) in 3 (20%). Ten of the patients with stage 3 disease were treated by combined surgery and full-dose mediastinal irradiation; in 2 resection was not possible and they were treated with irradiation alone. One of the patients with stage 3 disease developed progressive thymoma (median follow-up 74 months). This patient and 2 others died; 1 from mediastinitis after surgery for thymic carcinoma and 1 of unrelated disease. Both patients treated by irradiation alone were free of disease at follow-up. In the patients with stage 3 disease, the relapse rate was 8% (crude) and the 5-year disease-free survival rate 86% (life table). The patients with stage 4 disease received cisplatin-based combination chemotherapy, which was combined with further irradiation and debulking surgery in 2 of the 3 cases. These patients died of malignant disease at between 5 and 42 months, although 1 had a temporary response to chemotherapy. Tumour extent is the most important prognostic factor in these patients. A multidisciplinary approach to therapy is required.
Abratt
R P
RP
Department of Radiotherapy, University of Cape Town.
Willcox
P A
PA
de Groot
M
M
Geddes
C H
CH
Chetty
R
R
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013945:Thymoma / Q000628:therapy*; D013953:Thymus Neoplasms / Q000628:therapy*