Skip to main content
Top
Published in: Annals of Surgical Oncology 1/2014

01-01-2014 | Thoracic Oncology

Video-Assisted Thoracoscopic Surgical Thymectomy to Treat Early Thymoma: A Comparison with the Conventional Transsternal Approach

Authors: Tom J. Liu, MD, Mong-Wei Lin, MD, Min-Shu Hsieh, MD, Ming-Wei Kao, MD, Ke-Cheng Chen, MD, Chin-Chih Chang, MD, Shuenn-Wen Kuo, MD, Pei-Ming Huang, MD, Hsao-Hsun Hsu, MD, Jin-Shing Chen, MD, PhD, Hong-Shiee Lai, MD, PhD, Jang-Ming Lee, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2014

Login to get access

Abstract

Background

For thymoma, the feasibility of resection via video-assisted thoracoscopic surgery (VATS) remains controversial. The objective of our study was to compare the outcomes of VATS and transsternal thymectomy in order to evaluate the efficacy of the VATS method for treatment of early stage thymoma.

Methods

This study is a retrospective study of 120 patients who underwent thymectomy of early stage thymoma (Masaoka stage I and II) in a single medical center from 1991 to 2010. Of these patients, 76 patients underwent VATS thymectomy (VATS group) and 44 patients underwent the conventional transsternal approach (sternotomy group). We applied the Kaplan–Meier method to estimate overall survival (OS), recurrence-free survival (RFS), and time to tumor recurrence (TTR) of these two groups.

Results

The mean follow-up time was 61.9 months in the VATS group and 69.7 months in the sternotomy group. There was no surgery-related mortality or major complication. The VATS group had smaller specimen size (p < 0.05) and tumor size (p < 0.01), shorter length of stay (LOS) in the hospital (p < 0.01), and shorter duration of chest tube drainage (p < 0.05) than the sternotomy group. There were no significant differences between the two groups for OS, RFS, and TTR.

Conclusions

In early stage thymoma, VATS thymectomy associated with shorter hospital LOS and shorter duration of pleural drainage compared with the conventional transsternal approach. Otherwise, the two approaches had similar oncologic outcomes during the mean 60-month follow-up period.
Literature
1.
go back to reference Engels EA, Pfeiffer RM. Malignant thymoma in the United States: demographic patterns in incidence and associations with subsequent malignancies. Int J Cancer. 2003;105:546–51.PubMedCrossRef Engels EA, Pfeiffer RM. Malignant thymoma in the United States: demographic patterns in incidence and associations with subsequent malignancies. Int J Cancer. 2003;105:546–51.PubMedCrossRef
2.
go back to reference Hung YS, Chang CL, Chang H, Lu CH, Chen PT, Chou WC. Thymoma. J Intern Med Taiwan. 2009;20:344–51. Hung YS, Chang CL, Chang H, Lu CH, Chen PT, Chou WC. Thymoma. J Intern Med Taiwan. 2009;20:344–51.
3.
go back to reference Masaoka A, Monden Y, Nakahara K, Tanioka T. Follow-up study of thymomas with special reference to their clinical stages. Cancer. 1981;48:2485–92.PubMedCrossRef Masaoka A, Monden Y, Nakahara K, Tanioka T. Follow-up study of thymomas with special reference to their clinical stages. Cancer. 1981;48:2485–92.PubMedCrossRef
4.
go back to reference Kondo K, Monden Y. Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan. Ann Thorac Surg. 2003;76:878–84.PubMedCrossRef Kondo K, Monden Y. Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan. Ann Thorac Surg. 2003;76:878–84.PubMedCrossRef
5.
go back to reference Moore KH, McKenzie PR, Kennedy CW, McCaughan BC. Thymoma: trends over time. Ann Thorac Surg. 2001;72:203–7.PubMedCrossRef Moore KH, McKenzie PR, Kennedy CW, McCaughan BC. Thymoma: trends over time. Ann Thorac Surg. 2001;72:203–7.PubMedCrossRef
6.
go back to reference Gawrychowski J, Rokicki M, Gabriel A, Lackowska B, Czyzewski D. Thymoma—the usefulness of some prognostic factors for diagnosis and surgical treatment. Eur J Surg Oncol. 2000;26:203–8.PubMedCrossRef Gawrychowski J, Rokicki M, Gabriel A, Lackowska B, Czyzewski D. Thymoma—the usefulness of some prognostic factors for diagnosis and surgical treatment. Eur J Surg Oncol. 2000;26:203–8.PubMedCrossRef
7.
go back to reference Suster S, Moran CA. Histologic classification of thymoma: the World Health Organization and beyond. Hematol Oncol Clin North Am. 2008;22:381–92.PubMedCrossRef Suster S, Moran CA. Histologic classification of thymoma: the World Health Organization and beyond. Hematol Oncol Clin North Am. 2008;22:381–92.PubMedCrossRef
8.
go back to reference Tagawa T, Kometani T, Yamazaki K, et al. Prognosis and therapeutic response according to the World Health Organization histological classification in advanced thymoma. Surg Today. 2011;41:1599–604.PubMedCrossRef Tagawa T, Kometani T, Yamazaki K, et al. Prognosis and therapeutic response according to the World Health Organization histological classification in advanced thymoma. Surg Today. 2011;41:1599–604.PubMedCrossRef
9.
go back to reference Ruffini E, Filosso PL, Mossetti C, et al. Thymoma: inter-relationships among World Health Organization histology, Masaoka staging and myasthenia gravis and their independent prognostic significance: a single-centre experience. Eur J Cardiothorac Surg. 2011;40:146–53.PubMedCrossRef Ruffini E, Filosso PL, Mossetti C, et al. Thymoma: inter-relationships among World Health Organization histology, Masaoka staging and myasthenia gravis and their independent prognostic significance: a single-centre experience. Eur J Cardiothorac Surg. 2011;40:146–53.PubMedCrossRef
10.
go back to reference Davenport E, Malthaner RA. The role of surgery in the management of thymoma: a systematic review. Ann Thorac Surg. 2008;86:673–84.PubMedCrossRef Davenport E, Malthaner RA. The role of surgery in the management of thymoma: a systematic review. Ann Thorac Surg. 2008;86:673–84.PubMedCrossRef
11.
go back to reference Cheng YJ, Kao EL, Chou SH. Videothoracoscopic resection of stage II thymoma: prospective comparison of the results between thoracoscopy and open methods. Chest. 2005;128:3010–2.PubMedCrossRef Cheng YJ, Kao EL, Chou SH. Videothoracoscopic resection of stage II thymoma: prospective comparison of the results between thoracoscopy and open methods. Chest. 2005;128:3010–2.PubMedCrossRef
12.
go back to reference Agasthian T, Lin SJ. Clinical outcome of video-assisted thymectomy for myasthenia gravis and thymoma. Asian Cardiovasc Thorac Ann. 2010;18:234–9.PubMedCrossRef Agasthian T, Lin SJ. Clinical outcome of video-assisted thymectomy for myasthenia gravis and thymoma. Asian Cardiovasc Thorac Ann. 2010;18:234–9.PubMedCrossRef
13.
go back to reference Pennathur A, Qureshi I, Schuchert MJ, et al. Comparison of surgical techniques for early-stage thymoma: feasibility of minimally invasive thymectomy and comparison with open resection. J Thorac Cardiovasc Surg. 2011;141:694–701.PubMedCrossRef Pennathur A, Qureshi I, Schuchert MJ, et al. Comparison of surgical techniques for early-stage thymoma: feasibility of minimally invasive thymectomy and comparison with open resection. J Thorac Cardiovasc Surg. 2011;141:694–701.PubMedCrossRef
14.
go back to reference Thomas CR, Wright CD, Loehrer PJ. Thymoma: state of the art. J Clin Oncol. 1999;17:2280–9.PubMed Thomas CR, Wright CD, Loehrer PJ. Thymoma: state of the art. J Clin Oncol. 1999;17:2280–9.PubMed
Metadata
Title
Video-Assisted Thoracoscopic Surgical Thymectomy to Treat Early Thymoma: A Comparison with the Conventional Transsternal Approach
Authors
Tom J. Liu, MD
Mong-Wei Lin, MD
Min-Shu Hsieh, MD
Ming-Wei Kao, MD
Ke-Cheng Chen, MD
Chin-Chih Chang, MD
Shuenn-Wen Kuo, MD
Pei-Ming Huang, MD
Hsao-Hsun Hsu, MD
Jin-Shing Chen, MD, PhD
Hong-Shiee Lai, MD, PhD
Jang-Ming Lee, MD, PhD
Publication date
01-01-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 1/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3228-7

Other articles of this Issue 1/2014

Annals of Surgical Oncology 1/2014 Go to the issue