Lung Cancer. 2016 Nov;101:22-27. doi: 10.1016/j.lungcan.2016.06.021. Epub 2016 Sep 7.
Limited thymectomy as a potential alternative treatment option for early-stage thymoma: A multi-institutional propensity-matched study.
Narm KS1, Lee CY1, Do YW1, Jung HS1, Byun GE1, Lee JG1, Kim DJ1, Hwang Y2, Park IK2, Kang CH2, Kim YT2, Cho JH3, Choi YS3, Kim J3, Shim YM3, Hwang SK4, Kim YH4, Kim DK4, Park SI4, Chung KY5; Korea Association for Research on the Thymus.
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: kychu@yuhs.ac.
For early-stage thymoma, complete thymectomy has classically been regarded as the standard treatment protocol. However, several studies have shown that limited thymectomy may be an alternative treatment option for thymoma. This study compared perioperative outcomes, survival, and recurrence rates between patients undergoing limited thymectomy and complete thymectomy.
Between January 2000 and December 2013, a total of 762 patients underwent thymectomy for stage I or II thymomas at four institutions participating in the Korean Association for Research on the Thymus. Patients were divided into two groups: limited thymectomy group (n=295) and complete thymectomy group (n=467). Comparative clinicopathological, surgical, and oncological features were reviewed retrospectively.
The median follow-up time was 49 months (range: 0.2-189 months). A propensity score-matching analysis, based on seven variables (age, sex, surgical approach, tumor size, WHO histological type, Masaoka-Koga stage, and adjuvant radiotherapy), was performed using 141 patients selected from each group. The 5- and 10-year freedom-from-recurrence rates in the limited thymectomy group were 96.3% and 89.7%, respectively, and those in the complete thymectomy group were 97.0% and 85.0%, respectively. No significant differences in these rates were observed between groups (p=0.86). A multivariate Cox regression analysis showed that overall survival and freedom-from-recurrence rates did not significantly differ by surgery extent (p=0.27, 0.66, respectively). Perioperative outcomes were better in the limited thymectomy group.
Limited thymectomy was not inferior to complete thymectomy with respect to recurrence, and had better perioperative outcomes. Limited thymectomy may be a viable treatment option for early-stage thymoma.
Complete thymectomy; Limited thymectomy; Recurrence; Thymectomy; Thymoma; Thymomectomy
10.1016/j.lungcan.2016.06.021
Neoplasm Staging*
Perioperative Period
Propensity Score*
Radiotherapy, Adjuvant/methods
Thymectomy/methods*
Thymoma/pathology*
Thymoma/radiotherapy
Thymoma/surgery*
Thymus Neoplasms/pathology*
Thymus Neoplasms/radiotherapy
Thymus Neoplasms/surgery*
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