Results of re-resection for recurrent thymomas.
BACKGROUND
The treatment of recurrent thymomas remains controversial.


METHODS
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. Reresection can be recommended in selected patients.
Regnard
J F
JF
Department of Thoracic and Vascular Surgery, Marie Lannelongue Hospital, Le Plessis Robinson, France.
Zinzindohoue
F
F
Magdeleinat
P
P
Guibert
L
L
Spaggiari
L
L
Levasseur
P
P
D000328:Adult; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010997:Pleural Neoplasms / Q000556:secondary; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013945:Thymoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D013953:Thymus Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome