title: Stage-based treatment for thymoma in due consideration of thymectomy: a single-center experience and comparison with the literature.
abstract: BACKGROUND
  Thymomas represent an uncommon and heterogeneous group of intrathoracic malignancies which require different treatments corresponding to their individual tumor stage. The objective of this study was to review the efficacy of our applied stage-based treatment for thymoma in due consideration of thymectomy.
  
  
  METHODS
  This is a single-center, institutional review board-approved retrospective study of 50 consecutive patients with thymoma treated at our division within 10 years.
  
  
  RESULTS
  There were 29 women (58 %) and 21 men (42 %), mean age 58.3 years. Twenty nine (58 %) had clinical symptoms and 14 (28 %) had myasthenia gravis. Forty-five patients (90 %) underwent thymectomy and complete resection was done in 42 cases (93.3 %). Histologic results were 6 subtype A, 5 AB, 8 B1, 12 B2, 12 B3, and 7 C. The Masaoka staging system revealed 20 stage I, 18 stage II, 6 stage III, and 6 stage IV. Two patients had neoadjuvant therapy and 25 received postoperative treatment. Five (11.1 %) had tumor recurrence, treated with re-resection. The 5-year disease-free survival was 91.5 %. Two patients died of tumor progression and three died of other causes (10 %). The 5-year overall survival was 82.3 % and the median survival time was 92.1 months. The 5-year survival rate after thymectomy was 87.2 % and the median survival was 92.1 months.
  
  
  CONCLUSIONS
  Complete resection still remains the mainstay in the treatment of non-metastatic thymoma and should be performed whenever feasible. Close multidisciplinary teamwork is mandatory to optimize the neurologic outcome and to prolong postoperative survival.
authors.affiliation: Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University Graz, Auenbruggerplatz 29, 8036, Graz, Austria. jo.lindenmann@medunigraz.at.
authors.forename: Joerg
authors.initials: J
authors.lastname: Lindenmann
authors.affiliation: Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University Graz, Auenbruggerplatz 29, 8036, Graz, Austria.
authors.forename: Nicole
authors.initials: N
authors.lastname: Fink-Neuboeck
authors.affiliation: Division of Oncology, Department of Internal Medicine, Medical University Graz, Graz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Pichler
authors.affiliation: Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University Graz, Auenbruggerplatz 29, 8036, Graz, Austria.
authors.forename: Udo
authors.initials: U
authors.lastname: Anegg
authors.affiliation: Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University Graz, Auenbruggerplatz 29, 8036, Graz, Austria.
authors.forename: Alfred
authors.initials: A
authors.lastname: Maier
authors.affiliation: Institute of Medical Informatics, Statistics and Documentation, Medical University Graz, Graz, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Smolle
authors.affiliation: Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University Graz, Auenbruggerplatz 29, 8036, Graz, Austria.
authors.forename: Freyja Maria
authors.initials: FM
authors.lastname: Smolle-Juettner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D013934:Thymectomy; D013945:Thymoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D013953:Thymus Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult