Fujimura S, Kondo T, Handa M, Shiraishi Y, Tamahashi N, Nakada T
J Thorac Cardiovasc Surg. 1987 May;93(5):708-14.
Sixty-six patients with thymoma have undergone surgical treatment since 1965 and have been assessed from the viewpoint of clinical manifestations and prognosis. Thirty-one patients with encapsulated thymoma were treated with total surgical resection alone, and they had no postoperative tumor recurrence. With the exception of one patient who died of respiratory insufficiency on the fourth day after the operation, 34 patients with invasive thymoma were evaluated on the basis of their postoperative prognosis. Fifteen patients with invasive thymoma died from 1 1/2 months to 10 years, 1 month postoperatively; 9 died of local or metastatic tumor and 6 died of other diseases. Associated autoimmune diseases, as well as the invasive tendency of the tumors, apparently affected the prognosis. Ten-year survival rates of the patients who underwent surgical treatment were as follows: 61.6% for the total group, 74.3% for those with encapsulated thymoma, and 49.4% for those with invasive thymoma. In the surgical treatment for invasive thymomas, one should aim to resect the tumor totally, even though adjacent tissues are resected simultaneously. Even for the patient with total resection of invasive tumor, postoperative radiation should be required. Finally, if residual tumor must be left during the operation, postoperative radiation as well as anticancer chemotherapy should be aggressively scheduled, because postoperative distant metastasis may appear in these patients with residual thymoma.
自1965年以来，66例胸腺瘤患者接受了手术治疗，并从临床表现和预后的角度进行了评估。31例包膜型胸腺瘤患者仅接受了手术全切治疗，术后无肿瘤复发。除1例患者术后第4天死于呼吸功能不全外，对34例浸润型胸腺瘤患者根据其术后预后进行了评估。15例浸润型胸腺瘤患者在术后1个半月至10年1个月内死亡；9例死于局部或转移性肿瘤，6例死于其他疾病。相关自身免疫性疾病以及肿瘤的浸润倾向显然影响了预后。接受手术治疗患者的10年生存率如下：全组为61.6%，包膜型胸腺瘤患者为74.3%，浸润型胸腺瘤患者为49.4%。在浸润型胸腺瘤的手术治疗中，即使同时切除相邻组织，也应争取将肿瘤全切。即使对于浸润性肿瘤全切的患者，术后也应进行放疗。最后，如果术中必须残留肿瘤，应积极安排术后放疗及抗癌化疗，因为这些残留胸腺瘤患者术后可能会出现远处转移。
