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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2015

01-04-2015 | Thoracic Oncology

Long-Term Outcomes After Thoracoscopic Resection of Stage I and II Thymoma: A Propensity-Matched Study

Authors: Yin-Kai Chao, MD, PhD, Yun-Hen Liu, MD, Ming-Ju Hsieh, MD, Yi-Cheng Wu, MD, Tzu-Ping Chen, MD, Ming-Shian Lu, MD, Hung-I Lu, MD, Hui-Ping Liu, MD

Published in: Annals of Surgical Oncology | Issue 4/2015

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Abstract

Purpose

The use of video-assisted thoracoscopic surgery (VATS) in patients with thymoma remains controversial. We sought to evaluate the perioperative and oncological outcomes after VATS resection for stage I and II thymoma and to compare the outcomes with those obtained after median sternotomy (MST).

Methods

Between 1991 and 2007, a total of 140 patients with stage I and II thymoma underwent surgery at the Chang Gung Memorial Hospital. Of them, 58 underwent MST, 61 VATS, and 21 thoracotomy. Using a propensity score based on four variables (myasthenia gravis, tumor size on CT images, age, and Masaoka stage), 48 VATS-treated patients were matched to 48 patients who received MST. Outcomes compared included perioperative complications, length of stay, tumor recurrence, and survival.

Results

No operative deaths occurred in this study. VATS was associated with fewer intraoperative blood loss, and more patients in the VATS group were extubated in the operating room after surgery compared with the MST group (37.5 vs. 12.5 %, respectively, P = 0.005). The mean length of stay was shorter in the VATS group than in the MST group (5.8 vs. 7 days, respectively; P = 0.008). After a median follow-up of 53 months, five patients developed recurrent tumors (four pleural and one pericardial). No statistically significant differences were found in the 5-year survival rates between the two study groups.

Conclusions

VATS appears feasible for patients with stage I and II thymoma and is associated with better perioperative outcomes than MST. The oncological outcomes are also similar.
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Metadata
Title
Long-Term Outcomes After Thoracoscopic Resection of Stage I and II Thymoma: A Propensity-Matched Study
Authors
Yin-Kai Chao, MD, PhD
Yun-Hen Liu, MD
Ming-Ju Hsieh, MD
Yi-Cheng Wu, MD
Tzu-Ping Chen, MD
Ming-Shian Lu, MD
Hung-I Lu, MD
Hui-Ping Liu, MD
Publication date
01-04-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 4/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4068-9

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