Chest
Clinical Investigations: TumorsPrognostic and Clinical Relevance of the World Health Organization Schema for the Classification of Thymic Epithelial Tumors: A Clinicopathologic Study of 108 Patients and Literature Review
Section snippets
Patients and Surgical Strategy
One hundred twenty-six consecutive patients with thymoma were treated at our institute during the period from January 1992 to June 2002. Eighteen patients were excluded from the study: 6 patients who were initially treated elsewhere, 4 patients who received preoperative chemotherapy or radiotherapy, 7 patients in whom open biopsy alone was performed, and 1 patient who died of sepsis after operation. Therefore, a total of 108 cases of thymoma were considered for review.
Our goals in the surgical
Clinical Features
There were 63 male patients (58.3%) and 45 female patients (41.7%), with a mean age of 46.5 ± 13.8 years (± SD) [range, 20 to 83 years]. Fifty-one patients (47.2%) were in stage I, 35 patients (32.4%) were in stage II, 13 patients (12.0%) were in stage III, and 9 patients (8.3%) were in stage IV. MG was associated in 44 patients (40.7%). The treatment profiles of these 108 patients are summarized in Table 1. Our strategies in the adjuvant therapy were as follows: no adjuvant therapy in stage I
Discussion
In this study, the histologic subtype based on the WHO classification could be determined in all the 108 patients. Among the histologic subtypes, the most frequent histologic subtype was type B2 (29.6%), followed by type AB (23.1%). In our series, type A was more unusual (seven cases, 6.5%) than those in the other studies,12, 14, 16, 17 which reported the proportion of type A to be 13.8 to 22.0%. Although a larger proportion of the type A thymoma in other studies might result from a failure to
Conclusion
In the present study, the Masaoka stage is the most important determinant of survival in the thymoma patients. A prognostic value of the WHO histologic classification was noted when the schema was simplified and to bring the entity into three subgroups (A-B2/B3/C). To clarify the prognostic relevance and clinical usefulness of the WHO schema, certain prerequisites or consensus are necessary in the future studies.
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