Author of

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  P26 - Mesothelioma, Thymoma and Other Thoracic Malignancies - Thymic Malignancies (ID 218)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Mesothelioma, Thymoma and Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 35986

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    P26.07 - Video-Assisted Thoracoscopic Surgery for Stage I Thymoma: Short-Term Outcomes and Appropriate Indications (ID 2410)

    00:00 - 00:00  |  Presenting Author(s): Takahiro Suzuki
    • Abstract
    • Slides

    Introduction
    

    The purpose of this study was to evaluate the acceptable indications and short-term outcomes of video-assisted thoracoscopic surgery (VATS) for c-stage I (T1N0M0 in the TNM 8th edition) thymoma.

    Methods
    

    We retrospectively reviewed clinicopathological data of 151 surgically treated c-stage I thymoma patients between 2003 and 2018, and compared surgical outcomes of 50 patients who underwent VATS approach with 101 cases of open approach. The VATS approach was basically indicated for small tumors (radiological size ≤ 3cm) and was defined as procedures conducted using intercostal trocars without incisions longer than 3cm. Other procedures, including median sternotomy (n = 82) and thoracotomy with thoracoscopic assistance (n = 19), were classified as open approach. During the VATS approach, thymus was partially resected with an adequate surgical margin, but 7 (14%) patients with myasthenia gravis (MG) underwent total thymectomy by bilateral VATS approach.

    Results
    

    The VATS approach was planned in 50 patients, 48 patients were completed as planned, and 2 were converted to sternotomy due to adhesion of tumors to ascending aorta and left brachiocephalic vein. Tumor diameter was smaller in VATS group than in open group (2.77cm vs.4.56 cm, p<0.01), though VATS group contained 16 tumors larger than 3cm. In VATS group, all cases were pT1 and one (2%) case had R1 resection. Open group contained 90 cases of pT1 and 11 cases of pT2-4, 8 cases of R1 and 3 cases of R2 resections. As for the R1 resection case in VATS group, tumor size was 3.4 cm and had a positive margin with mediastinal fat tissue adjacent to. Retrospectively, CT showed a partial irregular margin of the tumor adjacent to pericardium. Besides shorter operative time (134min vs.171 min, p<0.01) in VATS group than in open group, there was no difference in the amount of blood loss (62ml vs.175ml, p=0.09), length of postoperative hospital stay (7.1days vs.12.0 days, p = 0.13) and complications (≥grade 2, 6% vs.10%,p = 0.50). In VATS group, 21 patients were followed longer than 5 years, no one had recurrence nor mortality.

    Conclusion
    

    The VATS approach has been safely performed for a small (radiological size ≤3cm) c-stage I thymoma and the short-term outcomes were acceptable.

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