PREOPERATIVE RADIOTHERAPY AND SURGERY FOR ADVANCED THYMOMA WITH INVASION TO THE GREAT-VESSELS

From 1983 to 1994, 12 advanced thymomas with invastion to the great ve ssels were initially treated by irradiation (mean dose, 18.3 Gy) and s ubsequent surgical resection. In nine patients, complete resection was possible by concomitant resection of the surrounding tissues, mainly pericardium and/or brachiocephalic vein. Histologically, all tumors sh owed prominent fibrosis. Ten patients also received postoperative radi otherapy (mean dose, 42.3 Gy). Tumor-related deaths occurred in only t wo patients; one who did not receive postoperative irradiation 21 mont hs and one who had viable cells at the surgical margin 10 months after operation. However, there were also 2 patients who died of respirator y failure due to operation and/or irradiation, one 45 days and the oth er 7 years after the treatment. Preoperative radiotherapy could facili tate complete resection of the advanced thymomas. The prognosis of the patients treated with preoperative radiotherapy seemed fair if follow ed by adequate resection and subsequent irradiation. (C) 1996 Wiley-Li ss, Inc.