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

European Society of Thoracic Surgeons (ESTS) Thymic Working Group Participating Centers, Francesco Guerrera, Pierre Emmanuel Falcoz, Bernhard Moser, Dirk van Raemdonck, Andrea Bille', Alper Toker, Lorenzo Spaggiari, Luca Ampollini, Claudia Filippini, Pascal Alexandre Thomas, Bram Verdonck, Paolo Mendogni, Clemens Aigner, Luca Voltolini, Nuria Novoa, Miriam Patella, Sara Mantovani, Ivan Gomes Bravio, Charalambos ZisisAngela Guirao, Francesco Londero, Miguel Congregado, Gaetano Rocco, Bert Du Pont, Nicola Martucci, Matthias Esch, Alessandro Brunelli, Frank C Detterbeck, Federico Venuta, Walter Weder, Enrico Ruffini, Walter Klepetko, Anne Olland, Daisuke Nonaka, Berker Ozkan, Giorgio Lo Iacono, Cesare Braggio, Pier Luigi Filosso, Geoffrey Brioude, Paul van Schil, Mario Nosotti, Daniel Valdivia, Stefano Bongiolatti, Ilhan Inci, Rontogianni Dimitra, David Sànchez, William Grossi, Sergio Moreno-Merino, Martin Teschner

Research output: Contribution to journalArticlepeer-review

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.
Original languageEnglish
Pages (from-to)881-887
Number of pages7
JournalEur. J. Cardio-thorac. Surg.
Volume60
Issue number4
DOIs
Publication statusPublished - Oct 1 2021

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