Kondo Kazuya
Department of Oncological Medical Services, Institute of Health Biosciences, The University of Tokushima Graduate School, 18-15 Kuramoto-cho 3, Tokushima, 770-8509, Japan,
Gen Thorac Cardiovasc Surg. 2014 Aug;62(8):468-74. doi: 10.1007/s11748-014-0420-z. Epub 2014 Jun 10.
Thymoma is the most common tumor of the anterior mediastinum. This tumor is associated with unique paraneoplastic syndromes. The rarity of this tumor has somewhat obscured the optimal treatment for this disease. The World Health Organization classification system, which published in 1999, appears to be an advance in our understanding of thymoma. The Masaoka classification is now the most widely accepted and is an excellent predictor of the prognosis of thymoma. Now the International Thymic Malignancy Interest Group is currently engaged in the development of a validated formal TNM classification system for thymic malignancies. The optimal treatment of thymoma is performed according to its clinical stage. Surgery remains the mainstay of treatment for thymic epithelial tumors. Minimally invasive surgery including thoracoscopic surgery and robotic surgery for stage I and II thymomas is increasing now. The value of postoperative radiotherapy in completely resected stage II or III tumors is questionable. As thymomas have a moderate response rate to chemotherapy or radiotherapy, multimodality therapy involving surgery, chemotherapy and radiotherapy appears to increase the rate of complete resection and survival in the advanced (stage III and IV) thymomas.
胸腺瘤是前纵隔最常见的肿瘤。这种肿瘤与独特的副肿瘤综合征相关。该肿瘤的罕见性在一定程度上掩盖了针对这种疾病的最佳治疗方法。1999年发布的世界卫生组织分类系统似乎是我们对胸腺瘤认识的一个进步。马萨oka分类法现在是最广泛接受的，并且是胸腺瘤预后的优秀预测指标。现在国际胸腺恶性肿瘤兴趣小组目前正在致力于开发一种经过验证的胸腺恶性肿瘤正式TNM分类系统。胸腺瘤的最佳治疗是根据其临床分期进行的。手术仍然是胸腺上皮肿瘤治疗的主要手段。目前，包括用于I期和II期胸腺瘤的胸腔镜手术和机器人手术在内的微创手术正在增加。完全切除的II期或III期肿瘤术后放疗的价值值得怀疑。由于胸腺瘤对化疗或放疗有中等反应率，涉及手术、化疗和放疗的多模式治疗似乎可以提高晚期（III期和IV期）胸腺瘤的完全切除率和生存率。
