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Limited thymectomy as a potential alternative treatment option for early-stage thymoma: A multi-institutional propensity-matched study

Authors
 Kyoung Shik Narm  ;  Chang Young Lee  ;  Young Woo Do  ;  Hee Suk Jung  ;  Go Eun Byun  ;  Jin Gu Lee  ;  Dae Joon Kim  ;  Yoohwa Hwang  ;  In Kyu Park  ;  Chang Hyun Kang  ;  Young Tae Kim  ;  Jong Ho Cho  ;  Yong Soo Choi  ;  Jhingook Kim  ;  Yong Mog Shim  ;  Su Kyung Hwang  ;  Yong-Hee Kim  ;  Dong Kwan Kim  ;  Seung-Il Park  ;  Kyung Young Chung 
Citation
 Lung Cancer, Vol.101(9) : 22-27, 2016 
Journal Title
 Lung Cancer 
ISSN
 0169-5002 
Issue Date
2016
MeSH
Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Staging* ; Perioperative Period ; Propensity Score* ; Radiotherapy, Adjuvant/methods ; Recurrence ; Retrospective Studies ; Survival ; Thymectomy/methods* ; Thymoma/pathology* ; Thymoma/radiotherapy ; Thymoma/surgery* ; Thymus Neoplasms/pathology* ; Thymus Neoplasms/radiotherapy ; Thymus Neoplasms/surgery*
Keywords
Complete thymectomy ; Limited thymectomy ; Recurrence ; Thymectomy ; Thymoma ; Thymomectomy
Abstract
OBJECTIVES: For early-stage thymoma, complete thymectomy has classically been regarded as the standard treatment protocol. However, several studies have shown that limited thymectomy may be an alternative treatment option for thymoma. This study compared perioperative outcomes, survival, and recurrence rates between patients undergoing limited thymectomy and complete thymectomy. MATERIALS AND METHODS: Between January 2000 and December 2013, a total of 762 patients underwent thymectomy for stage I or II thymomas at four institutions participating in the Korean Association for Research on the Thymus. Patients were divided into two groups: limited thymectomy group (n=295) and complete thymectomy group (n=467). Comparative clinicopathological, surgical, and oncological features were reviewed retrospectively. RESULTS: The median follow-up time was 49 months (range: 0.2-189 months). A propensity score-matching analysis, based on seven variables (age, sex, surgical approach, tumor size, WHO histological type, Masaoka-Koga stage, and adjuvant radiotherapy), was performed using 141 patients selected from each group. The 5- and 10-year freedom-from-recurrence rates in the limited thymectomy group were 96.3% and 89.7%, respectively, and those in the complete thymectomy group were 97.0% and 85.0%, respectively. No significant differences in these rates were observed between groups (p=0.86). A multivariate Cox regression analysis showed that overall survival and freedom-from-recurrence rates did not significantly differ by surgery extent (p=0.27, 0.66, respectively). Perioperative outcomes were better in the limited thymectomy group. CONCLUSION: Limited thymectomy was not inferior to complete thymectomy with respect to recurrence.
Full Text
http://www.sciencedirect.com/science/article/pii/S0169500216303798?via%3Dihub
DOI
10.1016/j.lungcan.2016.06.021
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Narm, Kyoung Shik(남경식)
Byun, Go Eun(변고은)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Chung, Kyung Young(정경영)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152002
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