What is included in postoperative care for thymoma?

Updated: Jul 27, 2020
  • Author: Kendrix J Evans, MD, MS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

Adjuvant radiation therapy [7] in completely or incompletely resected stage III or IV thymomas is considered a standard of care. The use of postoperative radiation therapy in stage II thymomas, however, has been questioned. 

Thymomas are indolent tumors that may take at least 10 years to recur; therefore, short-term follow-up will not depict relapses accurately. Furthermore, the gross appearance of tumor invasiveness is subjective, depending on the opinion of the surgeon. In one report from the Massachusetts General Hospital, five (22%) of 23 patients with stage II disease developed recurrences, leading to a proposed recommendation that postoperative radiation be instituted in all patients with stage II thymoma. [19]

In a study conducted by Curran et al that included 21 patients with stage II and III disease who did not undergo postoperative (total resection) radiation therapy, eight patients had recurrences in the mediastinum. [20] The five patients who received adjuvant radiation did not have recurrences.

A series from Memorial Sloan-Kettering Cancer Center, however, showed that adjuvant radiation therapy did not improve survival or decrease recurrence in stage II and III disease. [3] To reduce the incidence of local relapse, perform postoperative adjuvant radiation therapy in patients without completely encapsulated stage I tumors.


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