Seventeen years of surgical treatment of thymoma: factors influencing survival

We report on 17 years experience of the surgical treatment of thymoma in 65 patients, 11 with and 54 without myasthenia gravis. Patients were staged using the French "GETT" classification; 38 were in stage I (no invasive tumor), 6 in stage II, 13 in stage III and 8 in stage IV. In 45 patients, surgical excision was total while the remaining 20 underwent partial resection only. Postoperative radiotherapy was given in 12 cases, and 17 received a combination of radiotherapy and chemotherapy. One patient was lost to follow up, but no operative death occurred in the series. The mean survival for all patients was 70 +/- 7 months, and the 5- and 10-year survival was 91% +/- 4% and 69% +/- 8%, respectively. Follow-up for the 47 patients still alive and 4 patients deceased from unrelated causes ranged from 1.5 to 180 months (mean 142 +/- 10 months). Our data indicate that the prognosis of thymoma relates to radiological discovery (P less than 0.01), total surgical resection (P less than 0.01) and stage of tumor (P less than 0.01). It is not influenced by age, sex, tumor cell type or the presence or absence of myasthenia gravis.