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Diagnostic et traitement des tumeurs épithéliales thymiques

Diagnosis and treatment of epithelial thymic tumors

  • Article de Synthèse / Review Article
  • Published:
Journal Africain du Cancer / African Journal of Cancer

Résumé

Objectifs

Analyser les aspects diagnostiques et thérapeutiques des tumeurs épithéliales thymiques (TET).

Patients et méthodes

Étude rétrospective d’une série de cas. Les données démographiques, cliniques, thérapeutiques de la tumeur et du suivi de 23 patients, de janvier 2003 à décembre 2009, ont été recueillies. L’analyse descriptive a été réalisée par le logiciel SPSS.

Résultats

L’âge moyen a été de 45 ± 12,6 ans, le sex-ratio homme/femme = 1,6. La myasthénie a été présente dans 43,5 % des cas. 78,3 % des tumeurs ont été jugées d’emblée résécables. Un diagnostic préopératoire a été nécessaire dans 26 % des cas. La résection jugée complète de la tumeur a été réalisée dans 82,6 % des cas. Le traitement néoadjuvant a été sous forme d’une chimiothérapie (cinq cas), la possibilité de résection n’a été possible que dans un cas. La radiothérapie adjuvante a été indiquée chez six patients. La morbidité opératoire a été de 26 %. La survie postopératoire a été de 95 % avec une durée de suivi moyenne de 37 mois (extrêmes: 9–91 mois). Pour les patients non opérés, une seule patiente est en vie, deux patients sont décédés et un patient a été perdu de vue.

Conclusion

Les TETsont rares et restent les plus fréquentes des tumeurs thymiques, leur diagnostic est le plus souvent peropératoire. Les thymomes bien encapsulés relèvent d’un traitement chirurgical; par contre, les formes invasives nécessitent le plus souvent une approche multimodale. Le pronostic des tumeurs thymiques dépend étroitement du stade et de la qualité de l’exérèse.

Abstract

Objectives

To analyze diagnostic and therapeutic aspects of epithelial thymic tumors.

Patients and methods

This is a retrospective study of a case series. Data were collected on demographic, clinical, therapeutic and management aspects of the tumor in 23 patients seen between January 2003 and December 2009. These were analysed using SPSS software.

Results

The mean age was 45 ± 12.6 years, and male/female sex ratio was 1.6. Myasthenia was present in 43.5%. 78.3% of tumors were considered resectable. A pre-operative diagnosis was necessary in 26%. Complete resection of the tumor was performed in 82.6%. Neo-adjuvant treatment chemotherapy was administered in five cases; resection was possible in only one of those. Adjuvant radiotherapy was indicated in six patients. The operative morbidity was 26%. Post-operative survival rate was 95%, with a median follow-up of 37 months (range: 9-91 months). For nonoperated patients, one is alive, two have died and one was lost to follow-up.

Conclusion

Thymic epithelial tumors are rare and remain the most frequent thymic tumors. They are usually diagnosed per-operatively.Well-encapsulated thymomas are treated surgically. However, invasive forms require a multi-facetted approach. The prognosis of thymic tumors depends on the stage and on the extent of resection.

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Authors and Affiliations

  1. Service de chirurgie thoracique, hôpital militaire d’instruction, Mohammed-V, Rabat, Maroc

    F. Atoini, A. Traibi, A. Zidane, A. Arsalane, M. Elhammoumi, F. Elouieriachi & E. H. Kabiri

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  1. F. Atoini
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  2. A. Traibi
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  3. A. Zidane
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  7. E. H. Kabiri
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Correspondence to F. Atoini.

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Atoini, F., Traibi, A., Zidane, A. et al. Diagnostic et traitement des tumeurs épithéliales thymiques. J Afr Cancer 3, 256–262 (2011). https://doi.org/10.1007/s12558-011-0173-x

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  • DOI: https://doi.org/10.1007/s12558-011-0173-x

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