Patients with thymoma of all tissue types and all stages can develop distant metastases, and despite its long course and relatively good outcome, thymoma remains a malignant tumor. Due to the lack of prospective randomized controlled studies in clinical practice, there has been controversy about the reasonable comprehensive treatment model for thymoma. Based on the morphological characteristics of epithelial cells, the World Health Organization classifies thymic tumors into six pathological types, including A, AB, Bl, B2, B3, and C, among which type C is thymic carcinoma. At present, the clinical staging of thymoma still adopts Masaoka staging criteria. The current status and controversies of thymoma treatment are reviewed and discussed thematically. 1. Surgical treatment of thymoma: Surgery is the basic method of thymoma treatment. Almost all stage I thymomas and most stage II thymomas can be completely resected, and about 50% of stage III thymomas and about 25% of stage IV thymomas can be completely resected. The overall 5-year survival rate of patients with surgically resected thymoma is high. 10-year survival rates are 90% and 70% for stage I and II patients, respectively, and 55% and 35% for stage III and IVa patients, respectively. 15-year overall survival rates are 78%, 73%, 30% and 8% for stage I, II, III and IV patients, respectively. We retrospectively analyzed the outcome of 283 cases of thymoma treated mainly with surgery in our hospital. The 5-year overall survival rates were 94.3%, 86.3%, 71.6% and 39.4% for stage I, II, III and IV patients, respectively, and the 10-year overall survival rates were 84.3%, 75.4%, 56.6% and 29.6%, respectively. The completeness of tumor resection and Masaoka stage were the main prognostic factors for long-term survival of patients with thymoma. Patients with complete resection of thymoma had better survival, and the long-term survival rate after complete resection of stage III thymoma was similar to that of stage I thymoma. 2. Postoperative adjuvant radiotherapy for thymoma: Thymoma is a tumor sensitive to radiation therapy, and radiotherapy plays an important role in the treatment of thymoma. Although there is a lack of clinical randomized controlled studies, the available retrospective analysis of clinical data suggests that selective postoperative radiotherapy can benefit the survival of patients with thymoma. In the 1980s, postoperative radiotherapy was recommended for patients with all stages of thymoma, regardless of whether they were completely resected. More recent studies have focused on which stage of tumor or which resection status patients may benefit from postoperative radiotherapy. One study showed that the recurrence rate for patients with stage I and completely resected thymoma was 2% to 3% at 32 years of follow-up. Thus, it is concluded that patients with stage I thymoma are unlikely to benefit from postoperative radiotherapy. The results of a small randomized clinical trial from the Cancer Hospital of the Chinese Academy of Medical Sciences showed no survival benefit of postoperative radiotherapy for patients with stage I thymoma. A retrospective study (n=901) using SEER registry data also showed no therapeutic benefit of postoperative radiotherapy for patients with stage I thymoma. Adjuvant postoperative radiotherapy significantly improves overall survival in patients with stage II and III thymoma, especially in patients with non-completely resected mouths]. One study showed that the 5-year recurrence rate of those with stage II and III thymoma without radiotherapy after RO resection was 47%, whereas no recurrence was seen in patients who underwent postoperative radiotherapy. In 2009, a Meta-analysis of 592 patients showed no therapeutic benefit of postoperative radiotherapy in reducing recurrence in patients with completely resected stage II and III thymoma. utsumi et al. reported 324 patients treated surgically for thymoma, of whom 119 patients underwent postoperative radiotherapy, and concluded that stage I, II, and A, AB, and Bl patients are not recommended to receive postoperative radiotherapy. AB, and Bl patients were not recommended to receive adjuvant radiotherapy; and there was no statistically significant difference in survival rates for patients with stage III, stage IV, and types B2 and B3 regardless of whether they received postoperative radiotherapy. Although the evaluation of postoperative radiotherapy for thymoma has not been fully supported by evidence-based medicine, the preference in the literature is that postoperative radiotherapy is not recommended for stage I patients; postoperative radiotherapy is still recommended for patients with stage II and above, regardless of whether they are completely resected, as recommended by the National Comprehensive Cancer Network (NCCN) guidelines for the treatment of thymic tumors; for incompletely resected stage III and IV For stage III and IV patients with incomplete resection, postoperative radiotherapy is the standard of care. For patients with complete resection, the recommended dose of postoperative radiotherapy is 50-60 Gy; for patients with incomplete resection and large residual tumors, the total dose of postoperative radiotherapy should be >60 Gy. To reduce normal tissue complications and increase the dose of tumor irradiation, three-dimensional conformal or intensity-modulated radiotherapy techniques are recommended.