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KMID : 1140320200040040149
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Precision and Future Medicine
2020 Volume.4 No. 4 p.149 ~ p.160
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Surgical approach for the treatment of thymic carcinoma: 201 cases from a multi-institutional study
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Jeon Yeong-Jeong
Choi Yong-Soo
Cho Jong-Ho
Kim Hong-Kwan
Lee Geun-Dong
Kim Dong-Kwan
Kang Chang-Hyun
Kim Young-Tae
Lee Chang-Young
Lee Jin-Gu
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Abstract
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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.
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KEYWORD
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Thymus neoplasms, Carcinoma, Thoracic surgery, video-assisted
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