Skip to main content
The Management of Thymoma: A Systematic Review and Practice Guideline
Journal of Thoracic Oncology (2009)
  • Conrad B. Falkson
  • Andrea Bezjak
  • Gail Darling
  • Richard Gregg
  • Richard Malthaner, University of Western Ontario
  • Donna E. Maziak
  • Edward Yu, University of Western Ontario
  • Christopher A. Smith, McMaster University
  • Sheila McNair, McMaster University
  • Yee C. Ung
  • William K. Evans
  • Lung Cancer Disease Site Group of Cancer Care Ontario's Program in Evidence-Based Care, Lung Cancer Disease Site Group of Cancer Care Ontario's Program in Evidence-Based Care
INTRODUCTION: Thymoma is a rare tumor for which there is little randomized evidence to guide treatment. Because of the lack of high-quality evidence, a formal consensus-based approach was used to develop recommendations on treatment. METHODS: A systematic refview of the literature was performed. Recommendations were formed from available evidence and developed through a two-round modified Delphi consensus approach. RESULTS: The treatment recommendations are summarized as follows: Stage I--complete resection of the entire thymus without neoadjuvant or adjuvant therapy. Stage II--complete resection of the entire thymus with consideration of adjuvant radiation for high-risk tumors. Stage IIIA--surgery either initially or after neoadjuvant therapy, or surgery followed by adjuvant therapy. Stage IIIB--treatment may include a combination of chemotherapy, radiation, and/or surgery, or if technically possible, surgery in combination with chemoradiotherapy (concurrent cisplatin based). For bulky tumors, consideration should be given to sequential chemotherapy followed by radiation. Stage IVA--as per stage III, with surgery only if metastases can be resected. Stage IVB--treatment on an individual case basis (no generic recommendations). Recurrent disease--consider surgery, radiation, and/or chemoradiation. Chemoradiation should be considered in all medically inoperable and technically inoperable patients. CONCLUSION: Consensus was achieved on these recommendations, which serve to provide practical guidance to the physician treating this rare disease.
  • Combined Modality Therapy,
  • Delphi Technique,
  • Humans,
  • Neoplasm Metastasis,
  • Neoplasm Staging,
  • Thymoma,
  • Thymus Neoplasms
Publication Date
July, 2009
Citation Information
Conrad B. Falkson, Andrea Bezjak, Gail Darling, Richard Gregg, et al.. "The Management of Thymoma: A Systematic Review and Practice Guideline" Journal of Thoracic Oncology Vol. 4 Iss. 7 (2009)
Available at: