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J Cardiothorac Surg. 2009 Jul 15;4:33. doi: 10.1186/1749-8090-4-33.

The role of a pseudocapsula in thymic epithelial tumors: outcome and correlation with established prognostic parameters. Results of a 20-year single centre retrospective analysis.

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  • 1Clinic for Thoracic Surgery, Hugstetter Str, 55, University Hospital Freiburg, Albert-Ludwig-University, 79106 Freiburg, Germany. sebastian.dango@uniklinik-freiburg.de

Abstract

BACKGROUND:

Treatment of thymoma is often based on observation of only a few patients. Surgical resection is considered to be the most important step. Role of a pseudocapsula for surgery, its clinical significance and outcome compared with established prognostic parameters is discussed which has not been reported so far.

METHODS:

84 patients with thymoma underwent resection and analysis was carried out for clinical features, prognostic factors and long-term survival.

RESULTS:

Fifteen patients were classified in WHO subgroup A, 21 in AB, 29 in B and 19 patients in C. Forty two patients were classified in Masaoka stage I, 19 stage II, 9 stage III and 14 stage IV. Encapsulated thymoma was seen in 40, incomplete or missing capsula in 44 patients. In 71 complete resections, local recurrence was 5%. 5-year survival was 88.1%. Thymomas with pseudocapsula showed a significant better survival (94.9% vs. 61.1%, respectively) (p = 0.001) and was correlated with the absence of nodal or distant metastasis (p = 0.04 and 0.001, respectively). Presence of pseudocapsula as well as the Masaoka and WHO classification, and R-status were of prognostic significance. R-status and Masaoka stage appeared to be of independent prognostic significance in multivariate analysis.

CONCLUSION:

Intraoperative presence of an encapsulated tumor is a good technical marker for the surgeon to evaluate resectability and estimate prognosis. Although the presence of a capsula is of strong significance in the univariate analysis, it failed in the multivariate analysis due to its correlation with clinical Masaoka stage. Masaoka stage has a stronger relevance than WHO classification to determinate long-term outcome.

PMID:
19604398
[PubMed - indexed for MEDLINE]
PMCID:
PMC2717064
Free PMC Article
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