Thymomectomy plus total thymectomy versus simple thymomectomy for early-stage thymoma without myasthenia gravis: A European Society of Thoracic Surgeons Thymic Working Group Study Journal Article
| Authors: | Guerrera, F.; Falcoz, P. E.; Moser, B.; van Raemdonck, D.; Bille, A.; Toker, A.; Spaggiari, L.; Ampollini, L.; Filippini, C.; Thomas, P. A.; Verdonck, B.; Mendogni, P.; Aigner, C.; Voltolini, L.; Novoa, N.; Patella, M.; Mantovani, S.; Bravio, I. G.; Zisis, C.; Guirao, A.; Londero, F.; Congregado, M.; Rocco, G.; Du Pont, B.; Martucci, N.; Esch, M.; Brunelli, A.; Detterbeck, F. C.; Venuta, F.; Weder, W.; Ruffini, E.; on behalf of the European Society of Thoracic Surgeons (ESTS) Thymic Working Group Participating Centers; Klepetko, W.; Olland, A.; Du Pont, B.; Nonaka, D.; Ozkan, B.; Lo Iacono, G.; Braggio, C.; Filosso, P. L.; Brioude, G.; van Schil, P.; Nosotti, M.; Valdivia, D.; Bongiolatti, S.; Inci, I.; Dimitra, R.; Sànchez, D.; Grossi, W.; Moreno-Merino, S.; Teschner, M. |
| Article Title: | Thymomectomy plus total thymectomy versus simple thymomectomy for early-stage thymoma without myasthenia gravis: A European Society of Thoracic Surgeons Thymic Working Group Study |
| Abstract: | OBJECTIVES: Resection of thymic tumours including the removal of both the tumour and the thymus gland (thymothymectomy; TT) is the procedure of choice and is recommended in most relevant articles in the literature. Nevertheless, in recent years, some authors have suggested that resection of the tumour (simple thymomectomy; ST) may suffice from an oncological standpoint in patients with early-stage thymoma who do not have myasthenia gravis (MG) (non-MG). The goal of our study was to compare the short-and long-term outcomes of ST versus TT in non-MG early-stage thymomas using the European Society of Thoracic Surgeons thymic database. METHODS: A total of 498 non-MG patients with pathological stage I thymoma were included in the study. TT was performed in 466 (93.6%) of 498 patients who had surgery with curative intent; ST was done in 32 (6.4%). The completeness of resection, the rate of complications, the 30-day mortality, the overall recurrence and the freedom from recurrence were compared. We performed crude and propensity score-adjusted comparisons by surgical approach (ST vs TT). RESULTS: TT showed the same rate of postoperative complications, 30-day mortality and postoperative length of stay as ST. The 5-year overall survival rate was 89% in the TT group and 55% in the ST group. The 5-year freedom from recurrence was 96% in the TT group and 79% in the ST group. CONCLUSION: Patients with early-stage thymoma without MG who have a TT show significantly better freedom from recurrence than those who have an ST, without an increase in postoperative morbidity rate. © 2021 The Author(s). Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. |
| Keywords: | survival; recurrence; thymoma; thymectomy; extended thymectomy; thymomectomy; thymothymomectomy |
| Journal Title: | European Journal of Cardio-Thoracic Surgery |
| Volume: | 60 |
| Issue: | 4 |
| ISSN: | 1010-7940 |
| Publisher: | Oxford University Press |
| Date Published: | 2021-10-01 |
| Start Page: | 881 |
| End Page: | 887 |
| Language: | English |
| DOI: | 10.1093/ejcts/ezab224 |
| PROVIDER: | scopus |
| PUBMED: | 34023891 |
| PMCID: | PMC10060729 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 December 2021 -- Source: Scopus Correction published: DOI: 10.1093/ejcts/ezab316 |
