Thymectomy linked to increased risk of death and cancer, study shows

Thymectomy in adults is associated with an increased risk of death from any cause and cancer, according to a study published in The New England Journal of Medicine.

There was also an increased risk of autoimmune disease when patients with preoperative infection, cancer and autoimmune disease were excluded.

“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,” wrote the researchers, from Massachusetts General Hospital in Boston.

They examined the risk for death, cancer and autoimmune disease among more than 1100 adults who had undergone thymectomy compared with geographically age-matched controls who had undergone similar cardiothoracic surgery without thymectomy.

The researchers found that all-cause mortality was higher in the thymectomy group versus the control group five years after surgery (8.1% vs 2.8%), as was the risk for cancer (7.4% vs 3.7%).

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% vs 7.9%).

All-cause mortality and mortality due to cancer were higher in the thymectomy group versus the general US population in an analysis of all patients with more than five years’ follow-up with or without a matched control (9.0% vs 5.2% and 2.3% vs 1.5%, respectively).

More information: N Engl J Med 2023; 4 Aug.