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.

Thymomectomy plus total thymectomy versus simple thymomectomy for early-stage thymoma without myasthenia gravis: A European Society of Thoracic Surgeons Thymic Working Group Study / 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.; 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.; Sanchez, D.; Grossi, W.; Moreno-Merino, S.; Teschner, M.. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 60:4(2021), pp. 881-887. [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

Filosso P. L.;
2021-01-01

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.
60
4
881
887
Thymomectomy plus total thymectomy versus simple thymomectomy for early-stage thymoma without myasthenia gravis: A European Society of Thoracic Surgeons Thymic Working Group Study / 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.; 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.; Sanchez, D.; Grossi, W.; Moreno-Merino, S.; Teschner, M.. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 60:4(2021), pp. 881-887. [10.1093/ejcts/ezab224]
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.; 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.; Sanchez, D.; Grossi, W.; Moreno-Merino, S.; Teschner, M.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1294993
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