Thymoma surgery decreases risk second new: This article explores the topic in depth.
For example. Therefore,
Thymoma surgery decreases risk second:
What is the effect of thymectomy on the occurrence of cancers, especially non -thymic? Therefore. Meanwhile, After an American study published in The New England Journal of Medicine Who had thrown a pavement in the pond two years ago. For example. Therefore, a team from Cochin Hospital (AP-HP) retaliated with an analysis of postoperative monitoring at ten years from the Information Systems Medicalization Program (PMSI).
Over the 2014-2023 period, the authors show that thymoma surgery decreases at least 15 % the risk of non-thymic tumors. Meanwhile, Some cancers are avoided in particular, such as that of the lung. Moreover, The results are published online in The Journal of Thoracic and Cardiovascular Surgery.
Thymus surgery has developed for several decades to treat autoimmune myasthenia. For example, “At the same time. Meanwhile. However, thymus can be the seat of variable thymoma surgery decreases risk second new severity tumors, Explain to thymoma surgery decreases risk second Daily Professor Marco Alifano, chest surgeon at Cochin hospital. Consequently, Even if some thymomas are less aggressive. Similarly. Consequently, have been able to qualify for a time as “benign”, nosology has been revised and all are classified in malignant tumors. Meanwhile, Those whose grading is quite often less pejorative to histology can associate with an autoimmune myasthenia. However, »
Thymoma is a rare disease which is diagnosed in various circumstances: fortuitously during an imaging examination. Nevertheless. during myasthenia or other autoimmune diseases or in the event of a symptomatic form (voluminous, infiltrating and/or compressive tumors). Therefore, The risk of developing a second non -thymic cancer seems to be increased in patients with thymoma. even if the association is still debated. Thymectomy can be indicated for the treatment of myasthenia without thymoma. for the excision of a thymoma (thymomectomy. thymoma surgery decreases risk second new most often associated with total thymectomy), whether or not associated thymoma surgery decreases risk second with myasthenia.
Several studies have already evaluated the interest of thymectomy on myasthenia. “In the series, Thymectomy is beneficial in variable proportions, about half of the cases, describes the specialist. In myasthenia without thymoma, the benefit was very clear in a very rigorous randomized double blind trial. »» The survival of patients operated for Thymoma has been the subject of studies by institutional series. by international (ITMIG) or national (rhythmic) cooperative groups.
Thymoma surgery decreases risk second new
Thymoma surgery decreases risk second
The study that has waved certainties
However. in 2023. a team from Boston (Harvard/Massachusetts Hospital University), starting from the hypothesis that thymus remains necessary for overall health, had concluded with a reverse message. In this retrospective test. which had paired 1. 146 people who were operated on (more thymoma surgery decreases risk second new than 50 % without a malignant tumor of the thymus or other confirmed thymic pathology) to as many witnesses, surgery, at thymoma surgery decreases risk second five years, almost multiplied by 3 mortality all causes (8.1 % versus 2.8 % for the control group) and doubled the risk of other cancer (7.4 % versus 3.7 %). The risk of autoimmune diseases was also higher. after excluding patients who presented in preoperative infection, non-thymic cancer or autoimmune disease.
“This study led to many emotions at the time among oncologists and thoracic surgeons, recalls Professor Alifano. It was difficult for us to generalize these results because clinical experience suggested the opposite. especially since this work had methodological limits. »» The level of evidence was indeed moderate: the study could only be observed (because it would not be. ethical to randomize. take the risk of going on surgery in the event thymoma surgery decreases risk second new of thymoma). the inclusive population was heterogeneous (less than half had a malignant tumor of the thymus).
The PMSI with the rescue
This is how thymoma surgery decreases risk second the French team turned to PMSI. data to be clear. An analysis that was possible with the collaboration between clinicians and public health experts, including Dr Samir Bouyam, first author. “All cases hospitalized in France are listed there. whether they come from public. private, day -to -day and rehabilitation and rehabilitation hospitals, over ten years, over ten years continues the specialist. In addition. even if the data is anonymized, the chaining method allows you to know the future of a given person ”.
The French study included a total of 3,611 patients with a thymoma, including almost three -quarters (72.4 %, n = 2,616) had a thymectomy, or only (n = 2,114), or associated with radiotherapy (RT) with thymoma surgery decreases risk second new or without chemotherapy (CT) (n = 502). Some were not operated on but had RT or CT (16.6 %, n = 600), when others had no specific treatment (10.9 %, thymoma surgery decreases risk second n = 395).
During the follow -up, 361 patients presented another cancer: 184 in the surgery group alone (8.7 %), 48 in the surgery group with RT/CT (9.6 %), 66 in the RT/CT group (11 %) and 63 in the untreated group (15.9 %). The incidence of second cancer was thus lower in operated patients (30 per 1000 people-years [PA]) compared to those. who are not (53 per 1000 PA).
Certain cancers were significantly less frequent in operated: lung. female genital system, bone and cartilage, digestive system and central nervous system. Lung cancer was the one with the highest reduction in incidence (-21 %).
To explain their results. the authors put forward the thymoma surgery decreases risk second new hypothesis that the excision of a non -functional thymus could allow the immune system to rebalance. better combat tumors. “From our work. it appears that operated patients have the lowest risk of developing thymoma surgery decreases risk second new cancer, Summarizes Professor Alifano. Analysis by propensity scores, which makes it possible to overcome any factors of possible confusion, finds the same thing. If the reliability of our study is not as strong as a randomized prospective test. the exhaustiveness of the database erases inaccuracies. Operated patients seem to get closer to the risk of cancer of the general population. »»
Thymoma surgery decreases risk second new
Thymoma surgery decreases risk second
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