Surgical approach for the treatment of thymic carcinoma: 201 cases from a multi-institutional study
- Author:
Yeong Jeong JEON
1
;
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
;
Author Information
- Publication Type:Original Article
- From: Precision and Future Medicine 2020;4(4):149-160
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to compare the outcomes of surgical approach (video-assisted 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 conducted 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 postoperative 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 selectively employed in small (<5 cm) and TNM stage I tumor without compromise of oncologic outcome.
