Surgical approach for the treatment of thymic carcinoma: 201 cases from a multi-institutional study
Authors
Yeong Jeong Jeon ; Yong Soo Choi ; Jong Ho Cho ; Hong Kwan Kim ; Geun Dong Lee ; Dong Kwan Kim ; Chang Hyun Kang ; Young Tae Kim ; Chang Young Lee ; Jin Gu Lee
Citation
PRECISION AND FUTURE MEDICINE, Vol.4(4) : 149-160, 2020-12
Purpose: This study aimed to compare the outcomes of surgical approach (video-as sisted thoracoscopic surgery [VATS] vs. sternotomy vs. thoracotomy) for the treatment
ofthymic carcinoma
Methods: We retrospectively reviewed 201 patients with pathologically proven thymic
carcinoma who underwent surgicalresection atfour Korean institutions.
Results: From 2007 to 2013, 158 sternotomy, 33 VATS and 10 thoracotomy were con ducted forthymic carcinoma. Open group underwent more preoperative biopsy (41.8%
and 50% vs. 15.2%, P=0.012) and neoadjuvant treatment (22.2% and 30% vs. 0%,
P=0.008) than VATS group. In preoperative imaging, tumor size of VATS group was
smaller than sternotomy group (3.8±1.1 cm vs. 5.8±2 cm, P<0.05) and 91% of the
VATS group was clinicaltumor-node-metastasis (TNM) stage I. The lengths of chesttube
and mechanical ventilation duration, postoperative hospital day and intensive care unit
stay were shorterin VATS group than open group (P<0.001). The incidence of postoper ative complications of VATS group was lower than sternotomy group (P=0.014). The
5-year overall survival of the sternotomy, VATS and thoracotomy group were 100%,
100% and 87.5%±11.7%, respectively (P=0.107). The 5-year recurrence-free survival
rate was not significantly different between the groups (55.4%±4.5%, 67.9%±12.1%,
and 87.5%±11.7%; P=0.131)
Conclusion: The VATS approach of surgical treatment for thymic carcinoma can be se lectively employed in small (<5 cm) and TNM stage I tumor without compromise of on cologic outcome