Oncological Significance of WHO Histological Thymoma Classification: A Clinical Study Based on 286 Patients

Meinoshin Okumura, Mitsunori Ohta, Shinichiro Miyoshi, Takashi Mori, Tsutomu Yasumitsu, Kazuya Nakahara, Keiji Iuchi, Hiroto Tada, Hajime Maeda, Hikaru Matsuda

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)


Objectives: The clinical significance of thymoma histology remains controversial because of the numerous histological classifications of thymic epithelial tumors. Universal classification of such tumors was achieved by the World Health Organization (WHO) in 1999. We studied the prognostic significance of this classification. Methods: We studied clinical features and postoperative survival in cases of thymoma, but not thymic carcinoma, based on WHO histological classification in 286 patients undergoing surgery between 1958 and 2001. Results: Tumors were 19 type A, 79 type AB, 59 type B1, 102 type B2, and 27 type B3. The proportion of invasive tumors increased by type - from A to AB, B1, B2, and B3. The great vessels were involved more frequently in type B2 and B3 tumors than in type A, AB, and B1 tumors. The 20-year survival was 100% in type A, 87% in type AB, 91% in type B1, 65% in type B2, and 38% in type B3 tumors. Multivariate analysis showed Masaoka staging and WHO histological classification to be significant independent prognostic factors, while age, gender, myasthenia gravis association, resection completeness and great vessel involvement were not. In stage III patients, 13 of 45 patients with type B2 and B3 tumor died of their tumors, while no tumor deaths occurred in 11 patients with type A, AB, and B1 tumors. Conclusion: WHO histological classification realistically reflects the oncological behavior of thymoma.

Original languageEnglish
Pages (from-to)189-194
Number of pages6
JournalJapanese Journal of Thoracic and Cardiovascular Surgery
Issue number5
Publication statusPublished - May 2002
Externally publishedYes


  • Masaoka staging
  • Thymic epithelial tumor
  • Thymoma
  • WHO histological classification

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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