4 Aug 2023 • A recent study published in the NEJM evaluated 1420 patients who underwent thymectomy and 6021 controls. At 5 years after surgery, the thymectomy group had higher all-cause mortality (8.1% vs. 2.8%) and an increased risk of cancer (7.4% vs. 3.7%) compared to controls.

• The risk of autoimmune disease did not differ significantly between the groups in the overall primary cohort, but a difference was observed when patients with preoperative infection, cancer, or autoimmune disease were excluded from the analysis.
• In a longer follow-up analysis involving all patients, thymectomy group had higher all-cause mortality (9.0% vs. 5.2%) and cancer-related mortality (2.3% vs. 1.5%) compared to the general U.S. population.
• Among patients in whom T-cell production and plasma cytokine levels were measured, those who had undergone thymectomy had lower new production of CD4+ and CD8+ lymphocytes and higher levels of proinflammatory cytokines in the blood compared to controls.

The study concluded that thymectomy was associated with increased all-cause mortality, risk of cancer, and potentially autoimmune disease, suggesting the need for careful consideration of the risks and benefits of thymectomy procedures.

Source: NEJM | Read full story