AB047. Comparison of outcomes of minimally invasive surgery versus sternotomy for early-stage thymic epithelial tumors: a single-center retrospective analysis
Abstract

AB047. Comparison of outcomes of minimally invasive surgery versus sternotomy for early-stage thymic epithelial tumors: a single-center retrospective analysis

Hiromitsu Takizawa, Ayaka Baba, Emi Takehara, Taihei Takeuchi, Keisuke Fujimoto, Shinichi Sakamoto, Naoki Miyamoto, Hiroyuki Sumitomo, Atsushi Morishita, Naoya Kawakita, Hiroaki Toba

Department of Thoracic, Endocrine Surgery and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan

Correspondence to: Hiromitsu Takizawa, MD, PhD. Department of Thoracic, Endocrine Surgery and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15, Kuramotocho, Tokushima 770-8503, Japan. Email: takizawa@tokushima-u.ac.jp.

Background: In recent years, minimally invasive surgery for thymic epithelial tumors (TETs) has become more common. In this single-center retrospective study, we analyzed the surgical outcomes of patients who underwent minimally invasive surgery versus sternotomy for early-stage TETs.

Methods: We retrospectively reviewed 58 patients who underwent radical thymectomy for stage I TETs at Tokushima University Hospital between 2010 and 2023. Patients who underwent simple thymomectomy were excluded. The World Health Organization (WHO) classification was A, AB, B1, B2, B3, C, and others in 7, 6, 8, 17, 4, 6, and 10 cases, respectively. Surgical outcomes were evaluated by dividing patients into two groups: minimally invasive surgery including robotic surgery (group M) and sternotomy (group S). The majority of patients in group M were operated on via a subxiphoid approach. Recurrence-free survival (RFS) was evaluated by the Kaplan-Meier method.

Results: There were no significant differences in age and gender between the 30 patients in group M and the 28 patients in group S, and no significant differences in the proportion of patients with myasthenia gravis (17% vs. 39%, P=0.08). The tumor size was significantly smaller in group M (3.7±1.7 vs. 4.8±1.8 cm, P=0.02). There was no significant difference in the operation time between the two groups (188±55 vs. 186±51 min, P=0.87), but the blood loss was less in group M (14±22 vs. 180±226 mL, P<0.001). There was no significant difference in the incidence of postoperative complications between the two groups. Postoperative hospital stay was significantly shorter in the M group (7.2±3.2 vs. 12.9±14.3 days, P=0.049). There was no difference in recurrence-free survival between the two groups (5-year RFS: 87.7% vs. 91.3%, P=0.74).

Conclusions: Minimally invasive surgery for TETs was associated with less blood loss and shorter postoperative hospital stay. Although longer-term validation is needed, it may be as effective as sternotomy in terms of oncological outcomes.

Keywords: Thymic epithelial tumor (TET); minimally invasive surgery; sternotomy

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-24-ab047/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 (as revised in 2013). The study was approved by the Committee for Medical Ethics of Tokushima University Hospital (No. 3672) 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-24-ab047
Cite this abstract as: Takizawa H, Baba A, Takehara E, Takeuchi T, Fujimoto K, Sakamoto S, Miyamoto N, Sumitomo H, Morishita A, Kawakita N, Toba H. AB047. Comparison of outcomes of minimally invasive surgery versus sternotomy for early-stage thymic epithelial tumors: a single-center retrospective analysis. Mediastinum 2024;8:AB047.

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