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Objective: To analyze the clinical efficacy of intrathyroid thymic carcinoma (ITTC). Methods: This study retrospectively analyzed the clinical data of 21 patients with ITTC diagnosed and treated at the First Affiliated Hospital of Zhengzhou University from January 2018 to July 2023, including 9 males and 12 females, with a median age of 52 years (40-60 years old). Results: There is a correlation between the maximum diameter of the tumor (≥40 mm) and lymph node metastasis ( P =0.044). Seventeen patients received surgical treatment, and 4 patients only received chemotherapy. During the follow-up period, a total of 4 patients experienced death or progression, with a 2-year mortality or progression free survival rate of 74.8%. Conclusions: The prognosis of ITTC is good, and surgical treatment is the preferred treatment option, lymph node metastasis is significantly correlated with prognosis. The radiotherapy and chemotherapy of ITTC need to be determined based on the patient's condition.

Thymic tumor is a relatively rare type of thoracic cancer, which is pathologically-classified as thymic epithelial tumors by World Health Organization (WHO), including thymoma and thymic carcinoma. The incidence of thymic epithelial tumors in China is about 4.09 per million, which is slightly higher than that in European and American countries. For surgically-resectable thymic epithelial tumors, complete resection with or without postoperative radiotherapy or chemotherapy is preferred. For advanced unresectable disease, conventional radiotherapy and chemotherapy is the mainstream treatment but lack of standard first-line and second-line regimens. In recent years, targeted drugs and the immune checkpoint inhibitors have gradually exhibited certain therapeutic prospect in this subset of tumor. Since there was no guideline regarding thymic epithelial tumor released in China, Multidisciplinary Committee on Oncology, Chinese Physicians Association analyze, summarize and discuss the relevant research data for the diagnosis, treatment and prognosis of thymic epithelial tumors, and formulate the "Chinese guidelines for clinical diagnosis and treatment of thymic epithelial tumors (2021 Edition)" for clinicians' reference.

Objective: To evaluate the therapeutic effects of thymectomy in myasthenia gravis (MG) patients with thymoma., Methods: A total of 178 MG patients with thymectomy between July 2008 and December 2010 were included. All the subjects were received either cyclophosphamide alone or in combination with radiotherapeutic treatment after surgery. The MG absolute and relative clinical scores were used to assess the effectiveness of long-term treatments. Clinical evaluations were conducted before, and at 1 , 6, 12 and 24 months after operation. A comparative analysis on the inter-relationships among MG clinical presentation, WHO histology and Masaoka stage was also conducted., Results: (1) Of the 178 thymoma-patients, 103 were male and 75 were female, with a mean age of (43.7 +/- 12.5)-years old. One hundred and twelve cases were taken cyclophosphamide, and 58 cases with invasive thymoma (stages II , III and IV or WHO type B3 ) were taken cyclophosphamide in combination with radiotherapy. Five patients refused cyclophosphamide or radiotherapy and 3 did not finish treatment. (2) The muscular strength improved obviously in 32.8% (58/177) of the patients after 1 month after thymectomy, and 59.8% (101/169), 69.7% (115/165) and 81.5% (132/162) after 6 months, 1 year and 2 years, respectively with MG score for disease severity decreased significantly with time. (3) No significant differences of the improvement rates were observed in patients within different WHO histology category. However, the rates were much higher in patients with Masaoka stage I (91.4%) and stage I (89.8%) than those in patients with stage III (45.5%) and IV (28.6%) (all P < 0.001) ., Conclusions: The remission rate of MG patients with thymomas increase after thymectomy plus cyclophosphamide or in combination with radiotherapy and reached 81.5% after 2 years. The remission rate is associated with Masaoka stage, but not with WHO histology.

Objective: To summarize the clinical and pathologic features of thymoma and assess surgical treatment thereof., Methods: The clinical data of 66 thymoma patients, 35 males and 31 females, aged 40.8 (30 approximately 59), who underwent surgical treatment in the past 20 years, were analyzed. By Masaoka staging system, underwent extensive or radical or palliative operation, most commonly performed through a median sternotomy and frequently requires en-bloc resection of one or more adjacent structures., Results: Fourteen of the 66 patients had associated myasthenia gravis (MG). The most common symptoms included chest pain, MG, cough, and dyspnea; only 11 of the 66 (16.7%) patients had no symptom. Masaoka staging revealed stage I in 29 patients (43.9%), stage II in 16 (24.2%), stage III in 19 (28.8%), and stage IV in 2 (3.0%). Fourteen of the 66 patients underwent radical resection, resection of the whole thymus and thymoma, 40 underwent simple resection of thymus, 5 underwent palliative resection of thymoma, and 6 underwent thymectomy exploration. Recurrence of tumor was observed in 4 patients. Postoperative radiotherapy and chemotherapy were performed 24 h after the operation, mainly in the cases of invasive or metastatic thymoma. One patient died within 30 days after the operation., Conclusions: Resection and postoperative radiotherapy or chemotherapy are necessary in treatment of thymoma, particularly complete thymectomy.

Objectives: To study the diagnosis and treatment of thymoma and to assess prognosis factors., Methods: The clinical data on 116 patients with thymoma were collected. A retrospective analysis was performed by comparison of their survival rates computed by the actuarial method and rate of recurrence and metastasis., Results: Chest radiograph was used chiefly for the preoperative diagnosis of thymoma; myasthenia gravis (MG) (25.0%, 29/116) was the most common paraneoplastic disease. An extensive and radical resection was carried out to reduce the recurrence rate of thymoma with stage I and stage II (chi(2) = 4.941 P = 0.0219). The survival time was prolonged by postoperative radiotherapy and chemotherapy. A strong correlation was noted between the clinical stage and histologic subtype of M-H classification, by which the invasive behavior of thymoma was predicted (r = 0.385, P = 0.007). The 3-, 5-, and 10-year survival rates were 81.2%, 67.9% and 40.5%, respectively. Statistical analysis showed a significant negative correlation between stage and survival rate (r = -0.897, P = 0.0000)., Conclusion: The prognosis of thymoma depends mainly on the histologic subtype, clinical stage and multimodality treatment rather than paraneoplastic diseases.