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 sug- gested 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 compli- cations, the 30-day mortality, the overall recurrence and the freedom from recurrence were compared. We performed crude and propen- sity 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 sur- vival 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

Thymomectomy plus total thymectomy versus simple thymomectomy for early-stage thymoma without myasthenia gravis: a European Society of Thoracic Surgeons Thymic Working Group Study / F. Guerrera, P. Emmanuel Falcoz, B. Moser, D. van Raemdonck, A. Bille', A. Toker, L. Spaggiari, L. Ampollini, C. Filippini, P. Alexandre Thomas, B. Verdonck, P. Mendogni, C. Aigner, L. Voltolini, N. Novo, M. Patella, S. Mantovanit, I. Gomes Bravio, C. Zisis, A. Guirao, F. Londero, M. Congregado, G. Rocco, B. Du Pont, N. Martucci, M. Esch, A. Brunelli, F.C. Detterbeck, F. Venuta, W. Weder, E. Ruffini, W. Klepetko, A. Olland, B. Du Pont, D. Nonaka, B. Ozkan, G. Loiacono, C. Braggio, P. Luigi Filosso, G. Brioude, P. van Schil, M. Nosotti, D. Valdivia, S. Bongiolatti, I. Inci, R. Dimitra, D. Sa` nchez, W. Grossi, S. Moreno-Merino, M. Teschner. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - (2021), pp. ezab224.1-ezab224.7. [Epub ahead of print] [10.1093/ejcts/ezab224]

Thymomectomy plus total thymectomy versus simple thymomectomy for early-stage thymoma without myasthenia gravis: a European Society of Thoracic Surgeons Thymic Working Group Study

A. Bille';L. Spaggiari;P. Mendogni;M. Nosotti;
2021

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 sug- gested 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 compli- cations, the 30-day mortality, the overall recurrence and the freedom from recurrence were compared. We performed crude and propen- sity 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 sur- vival 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
Extended thymectomy; Recurrence; Survival; Thymectomy; Thymoma; Thymomectomy; Thymothymomectomy
Settore MED/21 - Chirurgia Toracica
23-mag-2021
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/858940
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