To investigate the surgical treatment of invasive thymoma invading adjacent great vessels.

A retrospective study on 36 patients with invasive thymoma invading adjacent great vessels was performed. The corresponding data including clinical presentation, operation procedure, adjuvant radio-chemotherapy and follow-up were reviewed.

All the patients were successfully operated without any intraoperative or hospital deaths. The tumors of 29 patients (81%) were completely resected. 14 patients underwent simple superior vena cava (SVC) reconstruction; 10 patients underwent left brachiocephalic vein (BCV) - right atrial appendage (RAA) reconstruction; 3 patients underwent right BCV - RAA reconstruction; 2 patients underwent left BCV-RAA reconstruction along with SVC resection; and other patients underwent complex vessel reconstruction (more than 1 vascular bridge). Ten patients (27.8%) had postoperative complications, including 5 cases of pulmonary infection, Two cases of electrolyte disturbance, 1 case of chylothorax, 1 case of atelectasis, and 1 case of haemothorax. Two patients died due to acute respiratory distress syndrome within 90 days after the surgery. Of the remaining patients, 13 cases (36%) experienced a relapse and finally 10 cases (27.8%) died. Compared to R1 resection group, R0 resection group had a better prognosis (P =0.048). The 3-year and 5-year survival rates were 79.1% and 58.8%, with median survival time of 84 months.

Reconstruction of mediastinal vessels for invasive thymoma is a feasible technology. Radical resection of the tumor with involved adjacent structures is the key to prolong overall survival for patients suffered from invasive thymoma.

Invasive thymoma; Vessel reconstruction; Prognosis