[Primary non-lymphoid thymic neoplasms. A study of 58 cases].
OBJECTIVE
Primary non-lymphoid thymus tumors (PNLTT) are an uncommon though quite varied pathology. Our objective was to identify the clinical, therapeutic and histologic variables with a prognostic value in these neoplasms.


METHODS
We studied 58 PNLTT cases, corresponding to 52 epithelial neoplams (PTEN), 4 thymolipomas (7%) and 2 neuroendocrine tumors (3%). Commonest clinical manifestations were myasthenia gravis (41%) and dyspnea (21%). Three patients were symptom-free (24%). We used Kaplan-Meier survival curves and Cox regression model.


RESULTS
All patients underwent surgery which consisted of thymectomy. Four patients underwent a biopsy procedure alone. Perioperative mortality was 3% (n = 2) and morbidity was 31% (n = 18), mainly because of respiratory and wound problems. 24 patients with PTEN, Masaoka degrees III and IV, and a patient with a lymphoepithelial carcinoma received adjuvant chemotherapy and/or radiotherapy. With a follow-up of 13 + 5 years, 12 PTEN patients and one patient with a neuroendrocrine tumor died as a consequence of the evolution of the disease. Cumulative survival was 80% at 5 years, 71% at 7 years and 63% at 10 years. There are currently two local relapses in two PTEN cases after 9 and 8 years of follow-up, respectively. Main prognostic factors are the histologic type and subtype and the clinical stage (p < 0.001).


CONCLUSIONS
In PNLTT early diagnosis is crucial in order to administer a correct treatment before the clinical stage is more advanced. Main prognostic factors are the histologic type and subtype and the clinical stage.
Ríos Zambudio
Antonio
A
Departamento de Cirugía, Servicio de Cirugía Torácica, Hospital Universitario Virgen de la Arrixaca, El Palmar, Avda. de la Libertad 208, 30007 Casillas, Murcia, España. ARZRIOS@teleline.es
Torres Lanzas
Juan
J
Galindo Fernández
Pedro José
PJ
Roca Calvo
María José
MJ
Alonso Romero
José Luis
JL
Sola Pérez
Joaquín
J
Parrilla Paricio
Pascual
P
D017668:Age of Onset; D001707:Biopsy, Needle; D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016019:Survival Analysis; D015996:Survival Rate; D019616:Thoracic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D013953:Thymus Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome