AB056. Surgical outcomes and prognostic impact of complete resection in thymic epithelial tumors: a 15-year experience from the National Cancer Institute of Mexico
Original Research

AB056. Surgical outcomes and prognostic impact of complete resection in thymic epithelial tumors: a 15-year experience from the National Cancer Institute of Mexico

Lilia Melissa Cruz-Cantu1, Jose Francisco Corona-Cruz1, Jesus Antonio Martin-Perez1, Miguel Angel Salinas Padilla1, Azalea Nazareth Olivares-Perez2, Luis Antonio Cabrera Miranda3, Federico Moreno-Avila3, Oscar Arrieta3, Federico Maldonado Magos4, Francisco Lozano-Ruiz4

1Thoracic Surgical Oncology, National Cancer Institute Mexico, Mexico City, Mexico; 2Oncologic anesthesia department, National Cancer Institute Mexico, Mexico City, Mexico; 3Thoracic Oncology Clinic, National Cancer Institute Mexico, Mexico City, Mexico; 4Radiation Oncology, National Cancer Institute Mexico, Mexico City, Mexico

Correspondence to: Jose Francisco Corona-Cruz, MD. Thoracic Surgical Oncology, National Cancer Institute Mexico, Avenida San Fernando number 22 seccion 16, Mexico City, 14080, Mexico. Email: drcoronacruz@gmail.com.

Background: Thymic epithelial tumors are rare, with thymoma being the most frequent histological subtype. The most important prognostic factors include tumor stage and completeness of surgical resection. We aim to describe retrospectively the demographic, clinical characteristics, surgical approach, histopathological results, postoperative complications, and oncological outcomes in patients undergoing thymectomy between 2009 and 2024 at the National Cancer Institute of Mexico.

Methods: This is a retrospective observational cohort study of patients who underwent thymectomy for thymic epithelial tumors at the National Cancer Institute of Mexico between January 2010 and December 2024. Primary endpoints were overall survival (OS) and disease-free survival (DFS).

Results: A total of 47 patients were included. Median follow-up was 50 months (range, 1–171 months). Mean age was 59 years, and 59% were female. Median tumor size was 8.4 cm (range, 3.0–18.0 cm). Paraneoplastic syndromes were present in 36%, with myasthenia gravis being the most common (25%). Neoadjuvant chemotherapy was administered in 13% of cases. A transsternal approach was used in 60% of cases; 8 patients underwent minimally invasive surgery [video-assisted thoracoscopic surgery (VATS) or robotic-assisted thoracic surgery (RATS)]. Extended thymectomy was required in 80% to achieve negative margins. Complete (R0) resection was achieved in 83% of patients. Most patients were Masaoka-Koga stage I (36.2%) and II (38.2%). Mos frequent histology was World Health Organization (WHO) AB (40.4%). Only 38.3% of patients received adjuvant treatment, with radiotherapy being the most common strategy (77.8%). The 90-day morbidity rate was 27.7%, mostly Clavien-Dindo grade I–II. Mortality was 6.4%. Median OS was 156 months (range, 22–289 months). Complete resection was the only factor significantly associated with improved OS: 155.0 months (range, 1.0–334.8 months) for R0 vs. 15.0 months (range, 1.0–93.4 months) for incomplete resections (P=0.14). DFS was also higher in patients with complete resection: 135.9 months (range, 111.0–160.8 months) vs. 69.3 months (range, 37.3–101.3 months) (P=0.07).

Conclusions: Our experience in the National Cancer Institute of Mexico demonstrate that Complete surgical resection is the cornerstone of curative treatment for thymic epithelial tumors. In our cohort, R0 resection was consistently associated with significantly improved overall and disease-free survival, regardless of tumor size or approach. These findings underscore the critical importance of achieving negative margins through tailored surgical strategies, including extended thymectomy when necessary.

Keywords: Thymoma; thymic carcinoma; surgery; survival

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-25-ab056/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the institutional ethics committee of the National Cancer Institute of Mexico (No. INCAN/CI/837/17) and individual consent for this retrospective analysis was waived.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/med-25-ab056
Cite this abstract as: Cruz-Cantu LM, Corona-Cruz JF, Martin-Perez JA, Salinas Padilla MA, Olivares-Perez AN, Miranda LAC, Moreno-Avila F, Arrieta O, Magos FM, Lozano-Ruiz F. AB056. Surgical outcomes and prognostic impact of complete resection in thymic epithelial tumors: a 15-year experience from the National Cancer Institute of Mexico. Mediastinum 2025;9:AB056.

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