Surgical approach for stage IVA thymoma -A clinical experience with 7 cases

Objective 　To discuss the safety and the outcome of surgical treatment for patient with ⅣA thymoma. Methods 　Seven patients with stage ⅣA thymoma were treated surgically between Jan. 2007 and Dec. 2014. Clinical data and follow-up information were collected and analyzed. Results 　The median age of the patients was 38 years old (range 27-57 years). There were four male patients. Tumor was located in the left thoracic cavity in four patients. In 5 patients it was synchronous primary thymoma (Stage ⅣA), and in 2 patients it was a recurrence after initial thymoma resection. Mean operation time was 10.4±2.8 hours, median blood loss was 1000(300-8200)ml, median postoperative stay in hospital was 14 (10-54) days. There was no postoperative death. Major postoperative complication occurred in 3 patients (42.9%). Minor postoperative complication occurred in 5 patients (71.4%). A mean of twelve lymph nodes (range 4-47) were resected, and lymph node metastasis was found in one patient. Median follow-up time was 24(5-81) months, and all patients except one survived without evidence of recurrence. One patient died of recurrence of tumor 81 months after surgery. Conclusions 　The recommended therapy for ⅣA stage thymoma is multidisciplinary, including radiation, chemotherapy, and surgery. In selected patient with stage ⅣA thymoma, surgical resection is a safe and effective procedure with a long survival time. The choice of resection should conform to the extent of disease and patientu0027s condition. DOI: 10.11855/j.issn.0577-7402.2016.01.11