Perioperative Outcomes and Long-term Survival in Clinically Early-stage Thymic Malignancies：Video-assisted Thoracoscopic Thymectomy versus Open Approaches
10.3779/j.issn.1009-3419.2016.07.07
- VernacularTitle:胸腔镜与开放手术治疗临床早期胸腺恶性肿瘤的围手术期效果及长期生存率的比较
- Author:
WANG HAO
1
;
GU ZHITAO
;
DING JIANYONG
;
TAN LIJIE
;
FU JIANHUA
;
SHEN YI
;
WEI YUCHENG
;
ZHANG PENG
;
HAN YONGTAO
;
CHEN CHUN
;
ZHANG RENQUAN
;
LI YIN
;
CHEN KE-NENG
;
CHEN HEZHONG
;
LIU YONGYU
;
CUI YOUBING
;
WANG YUN
;
PANG LIEWEN
;
YU ZHENTAO
;
ZHOU XINMING
;
LIU YANGCHUN
;
LIU YUAN
;
FANG WENTAO
Author Information
1. 复旦大学附属中山医院胸外科
- Keywords:
Thymic malignancies;
hTymectomy;
Video-assisted hToracoscopic Surgery (VATS);
Open surgery
- From:
Chinese Journal of Lung Cancer
2016;19(7):453-458
- CountryChina
- Language:Chinese
-
Abstract:
Background and objectiveVideo-assisted thoracoscopic surgery (VATS) theoretically offers advantages over open thymectomy for clinically early-stage (Masaoka-Koga stage I and II) thymic malignancies. However, longterm outcomes have not been well studied. We compared the postoperative outcomes and survival from a cohort study based on the database of the Chinese Alliance for Research in Thymomas (ChART).MethodsBetween 1994 and 2012, data of 1,117 patients hav-ing surgery for clinically early-stage (Masaoka-Koga stage I and II) tumors were enrolled for the study. Among them, 241 cases underwent VATS thymectomy (VATS group), while 876 cases underwent open thymectomy (Open group). Univariate analyses were used to compare the clinical character and perioperative outcomes between the two groups. And multivariate analysis was performed to determine the independent predictive factors for long-term survival.Results Compared with the Open group, the VATS group had higher percentage of total thymectomy (80.5%vs 73.9%,P=0.028), resection rate (98.8%vs 88.7%,P<0.001) and less recurrence (2.9%vs 16.0%,P<0.001). Five-year overall survival was 92% atfer VATS and 92% atfer open thymectomy, with no signiifcant difference between the two groups (P=0.15). However, 5-year disease free survival were 92% in VATS group and 83% in Open group (P=0.011).Cox proportional hazards model revealed that WHO classiifcation, Masaoka-Koga stage and adjuvant therapy were independent predictive factors for overall survival, while surgical approach had no signiifcant impact on long-term outcome.ConclusionhTis study suggests that VATS thymectomy is an effective approach for clinically early-stage thymic malig-nancies. And it may offer better perioperative outcomes, as well as equal oncological survival.
