Single Centre Experience in the Management of Thymic Tumours

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. We retrospectively reviewed clinical case notes, electronic patient records, imaging and radiation treatment records of patients treated at Clatterbridge Cancer Centre. 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). 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.