title: Clinical and pathologic predictors of survival in patients with thymic tumors.
abstract: BACKGROUND
  The aim of this study is to evaluate the impact of thymectomy in patients with thymic neoplasms and to identify clinical and histopathological factors associated with improved long-term outcome of surgery.
  
  
  METHODS
  We treated 74 patients between February 1987 and July 1993. There were 29 total and 36 simple thymectomies. These last cases, all non-myasthenic, had benign thymomas (n=30) but 6 had thymic carcinomas. Nine tumors were no-resected (5 thymomas and 4 thymic carcinomas). Minimum follow-up by Department of Thoracic Surgery Istituto Nazionale Tumori was 60 months after thymectomy. We divided the specimens according to Marino and Muller-Hermelink's classification: 54 thymomas, 18 thymic carcinomas and 2 no-diagnosis specify thymomas. There were 53 stage I, 1 stage II, 13 stage III, 5 stage IVa and 2 stage IVb according to Masaoka.
  
  
  RESULTS
  Forty-six patients with treated thymoma were alive without disease at the end of follow-up, the remaining 8 died from recurrence in 6, a new tumor in 1 and a heart attack in the last. Of 18 thymic carcinomas 9 were alive at the end of follow-up (1 with recurrence), only 4 dead from recurrence. The actuarial survival of patients with thymomas was 88.5% at 5 years, (73.6% in cortical type, 85.7% in medullary type, 93.9% in mixed type, 100% in predominantly cortical type). Myasthenia gravis didn't influence the survival: 87.3 (no MG) vs 90%. Advanced stage thymomas significantly increased the risk of death from early stage I: 32.4 vs 100% at 5 years. In thymic carcinoma patients with well-differentiated thymic carcinoma (WDTC) died less than others: the actuarial probability of survival at 5 years was 90 vs 68%.
  
  
  CONCLUSIONS
  Thymectomy was the best treatment to long term outcome. In our experience, survival was related to histotype and to local extension of tumor.
authors.affiliation: Department of Thoracic Surgery, Istituto Nazionale Tumori, Milano, Italy. lequaglie@istitutotumori.mi.it
authors.forename: C
authors.initials: C
authors.lastname: Lequaglie
authors.forename: G
authors.initials: G
authors.lastname: Giudice
authors.forename: P P
authors.initials: PP
authors.lastname: Brega Massone
authors.forename: B
authors.initials: B
authors.lastname: Conti
authors.forename: I
authors.initials: I
authors.lastname: Cataldo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D013934:Thymectomy; D013945:Thymoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D013950:Thymus Gland / Q000473:pathology; D013953:Thymus Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D013997:Time Factors