Single Centre Experience in the Management of Thymic Tumours

Background: Thymoma and thymic carcinoma are relatively rare tumours of the anterior mediastinum. Optimum treatment options for these tumours remain unresolved, although at present, a multimodality approach involving aggressive surgical resection, platinum-based combination chemotherapeutic interventions and radiotherapy represents the preferred therapeutic approach.1-3 This study evaluates the treatment outcome of patients with thymic tumours at our centre. Methods: We retrospectively reviewed clinical case notes, electronic patient records, imaging and radiation treatment records of patients treated at Clatterbridge Cancer Centre. Results: A total of 21 patients diagnosed with thymic tumours were treated at Clatterbridge Cancer Centre between June 1990 until June 2011. There were 12 (57%) out of 21 patients who received multimodality therapy (chemotherapy and/or radiation therapy and/or surgery), 7 (34%) received single modality treatment and 2 (9%) did not receive any treatment. Relapse occurred in 10 (47%) patients with a median time from primary diagnosis to relapse of 28 months (10 to 104 months). Among those who relapsed, 6 died with a median survival of 58 months (53 to 64 months). Out of 12 patients in the multimodality treatment group, 9 (75%) remain alive with a median follow up of 45 months. In 7 patients who received single mode therapy, 5 (71%) died with a median survival of 45 months. 2 patients who did not receive any treatment died. Overall median survival in 10 of 21 patients who died was 42 months (2 to 192 months). Conclusion: Multimodality treatment for thymic tumours represents the preferred therapeutic approach and should be considered in suitable patients. Further randomized trials are necessary to define the optimum treatment options.