J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 771KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 94(11): 1201-1208, 1993

Original article

LONG-TERM FOLLOW-UP RESULTS OF STAGE III AND IV THYMOMAS AND THYMIC CARCINOMAS INVADING THE GREAT VEINS

1) Tokyo National Chest Hospital, Tokyo, Japan
2) Department of Thoracic and Cardiovascular Surgery, Jichi Medical School, Tochigi, Japan

Kanahe Fukushima1), Tsutomu Ohara2), Tsutomu Yamaguchi2), Akira Take2), Osamu Kamisawa2), Yasunori Sohara2), Tsugou Hasegawa2)

A series of 24 patients with stage III and IV thymomas and thymic carcinomas were reviewed with respect to the invasiveness of the superior vena cava (SVC) and brachiocephalic veins(BCV). Masaoka staging revealed stage III disease in 14 patients and stage IV in 10. Follow-up ranged from 3 months to 12 years and 10 months. In 9 patients with stage III disease involving the great veins, 6 patients underwent total resection, 2 subtotal resection, and one exploratory thoracotomy. Reconstruction of SVC was done in 2 patients and of left BCV in 7 and angioplasty of SVC in one. Although there were 4 tumor deaths and one myasthenic death, 4 patients were alive and tumor free. The longest survival after total resection with SVC replacement was 11 years and 7 months. In 3 patients with stage IV disease invading the great veins, 2 patients underwent partial resection and one received radiotherapy alone. Although 2 patients died of generalized metastases and respiratory failure respectively, one remained alive 2 years and 2 months with carcinoma. Although long-term survivors were obtained in the patients with adventitial involvement, prognosis was poor in the patients with intimal invasion.

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