What is the prognosis of thymoma?

Updated: Dec 03, 2018
  • Author: Kendrix J Evans, MD, MS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

The prognosis is worse for patients with symptomatic thymomas because these patients are more likely to have a malignant thymoma. The single most important factor predicting the outcome of patients with thymomas is evidence of invasion. Histologic characteristics, such as microscopic capsular invasion, should be assessed. [2] The surgeon should perform a gross inspection. Cellular characteristics are inconsequential because they have no impact on patient treatment.

Because of the well-documented propensity for late recurrences, long-term survival should be considered in terms of a 10-year follow-up after treatment of the thymoma. A study conducted by the Memorial Sloan-Kettering Cancer Center reported 5-year and 10-year survival rates for various stages of thymomas (see Table 1 below). [3]

Table 1. Survival of Thymoma by Stage: Memorial Sloan-Kettering Experience (Open Table in a new window)

Stage

5-Year Survival

10-Year Survival

I

90%

80%

II

90%

80%

III

60%

30%

IV

Less than 25%

N/A

Thymomas are associated with the development of second malignancies. A review of the Surveillance, Epidemiology, and End Results (SEER) database of thymoma cases in the United States (1973-1988) identified 849 cases, of which 66 had second malignancies. There was an excess occurrence of non-Hodgkin lymphoma and soft-tissue sarcoma but of no other specific cancers. Notably, an increase in digestive system cancers (colon/rectum, stomach, esophagus, liver/biliary tract) occurred; however, these increases were not statistically significant.


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