The surgical treatment of invasive thymoma. Resection with vascular reconstruction.

We have treated 96 patients with thymoma during the past 27 years; 57 of them had invasive thymoma. Surgical resection was undertaken in 45 of the 57 patients with invasive thymoma, including 14 patients in whom tumors were extirpated with vascular reconstruction. In addition, six patients with other thymic malignancies were treated in the same way. In six patients only angioplasty was performed, whereas artificial grafts were used in the other 14 patients. Ten of the 20 patients are still alive and well. One has probably been cured, since no signs of recurrence have been noted during the postoperative follow-up period of 8 years. No complications or occlusive symptoms were observed in these patients postoperatively, except in one who died after gastrointestinal hemorrhage. In one patient long-term patency of the vascular graft was confirmed by angiography and magnetic resonance imaging 5 years after operation. This intensive surgical procedure improved the quality of life for patients with the superior vena caval syndrome and may also have improved the prognosis of the patients with invasive thymoma.