Thymoma is the most common neoplasm of the anterior mediastinum which originates from the epithelial cells of the thymus. Thymomas are typically slow-growing tumors that spread by local extension. Metastases are usually confined to the pleura, pericardium, or diaphragm, whereas extra thoracic metastases are uncommon. Surgery is the treatment of choice followed by adjuvant treatment in from of radiation and chemotherapy and role of debulking is still controversial. Paraneoplastic syndromes are associated with approximately 70 percent of cases.
Aims and objective: In this study tried to find out the role of different treatment options of thymoma, its outcome, prognostic factors in current scenario.
Material and methods: It is a retrospective analysis of 55 patients of histologically proven cases of thymoma out of which five cases were excluded due to Unresectability determined pre-operatively. Data collected from hospital data base from 1998 to year 2008.Tumor was staged according to Masaoka staging system and histopathological typing was done according to WHO classification. After clinical evaluation, staging work-up includes contrast enhanced computed tomography examination. Thymectomy was performed wherever feasible, if not then debulking was done.
Results: Average age of presentation was 51 years with male to female ratio of 1.2:1. 30% patients have associated myasthenia gravis syndrome. Cough was the most common symptom followed by dyspnoea and chest pain. Out of 50 patients 44% were Masoka’s stage I.35/50 underwent curative resection. Myasthenia crisis was reported in four patients whereas post-operative mortality was 7%. Reported five year survival was 60%.
Conclusion: Surgery remains the mainstay of treatment regardless of stage for all thymic neoplasms. extended Thymectomy should be done in advance cases. Ongoing studies showed benefit of neoadjuvant chemotherapy and radiation in locally advanced tumors. Resection margin is the most important predictor of recurrence, final outcome and determining factor for adjuvant treatment. Multidisciplinary team discussion is required before treatment planning.