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

Abstract

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.

Supplementary

The article’s supplementary files as

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.