Thymectomy in Adults Linked to All-Cause Mortality, Cancer

FRIDAY, Aug. 4, 2023 (HealthDay News) -- Thymectomy in adults is associated with an increased risk for death from any cause and cancer and may be tied to an increased risk for autoimmune disease, according to a study published in the Aug. 3 issue of the New England Journal of Medicine.

Kameron A. Kooshesh, M.D., from Massachusetts General Hospital in Boston, and colleagues examined the risk for death, cancer, and autoimmune disease among adults who had undergone thymectomy compared with demographically matched controls who had undergone similar cardiothoracic surgery without thymectomy (1,420 and 6,021 patients, respectively). The primary cohort included 1,146 patients who had undergone thymectomy and had a matched control.

The researchers found that all-cause mortality was higher in the thymectomy group versus the control group at five years after surgery (8.1 versus 2.8 percent; relative risk, 2.9), as was the risk for cancer (7.4 versus 3.7 percent; relative risk, 2.0). In the overall primary cohort, the risk for autoimmune disease did not differ significantly between the groups, but when patients with preoperative infection, cancer, or autoimmune disease were excluded from the analysis, a significant difference was observed (12.3 versus 7.9 percent; relative risk, 1.5). All-cause mortality and mortality due to cancer were higher in the thymectomy group versus the general U.S. population in an analysis of all patients with more than five years of follow-up, with or without a matched control (9.0 versus 5.2 percent and 2.3 versus 1.5 percent, respectively).

"The disruption of homeostasis caused by thymectomy is sufficient to adversely affect critical health outcomes, which argues strongly that the adult thymus remains functionally important," the authors write.

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