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KMID : 1812420220550020126
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Journal of Chest Surgery
2022 Volume.55 No. 2 p.126 ~ p.142
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An Overview of Surgical Treatment of Thymic Epithelial Tumors in Korea: A Retrospective Multicenter Analysis
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Lee Jun-Oh
Lee Geun-Dong
Kim Hyeong-Ryul
Kim Dong-Kwan
Park Seung-Il
Cho Jong-Ho
Kim Hong-Kwan
Choi Yong-Soo
Kim Jhin-Gook
Shim Young-Mog
Park Samina
Park In-Kyu
Kang Chang-Hyun
Kim Young-Tae
Park Seong-Yong
Lee Chang-Young
Lee Jin-Gu
Kim Dae-Joon
Paik Hyo-Chae
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Abstract
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Background: Thymic epithelial tumors (TETs) are rare, and information regarding their surgical outcomes and prognostic factors has rapidly changed in the past few decades. We analyzed surgical treatment practices for TETs and outcomes in terms of overall survival (OS) and freedom from recurrence (FFR) during a 13-year period in Korea.
Methods: In total, 1,298 patients with surgically resected TETs between 2000 and 2013 were enrolled retrospectively. OS and FFR were calculated using the Kaplan-Meier method and evaluated with the log-rank test. Prognostic factors for OS and FFR were analyzed with multivariable Cox regression.
Results: A total of 1,098 patients were diagnosed with thymoma, and 200 patients were diagnosed with thymic carcinoma. Over the study period, the total number of patients with surgically treated TETs and the proportion of patients who underwent minimally invasive thymic surgery (MITS) increased annually. The 5-year and 10-year survival rates of surgically treated TETs were 91.0% and 82.1%, respectively. The 5-year and 10-year recurrence rates were 86.3% and 80.0%, respectively. The outcomes of surgically treated TETs improved over time. Multivariable Cox hazards analysis for OS, age, tumor size, and Masaoka-Koga stage were independent predictors of prognosis. The World Health Organization classification and tumor-node-metastasis (TNM) staging were also related to the prognosis of TETs.
Conclusion: Surgical treatment of TETs achieved a good prognosis with a recent increase in MITS. The M-K stage was the most important prognostic factor for OS and FFR. The new TNM stage could also be an effective predictor of the outcomes of TETs.
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KEYWORD
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Thymic epithelial tumor, Thymectomy, Video-assisted thoracic surgery
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