Long-term oncological outcome in thymic malignancies: videothoracoscopic versus open thymectomy

Abstract

Complete resection is the standard of care for thymic malignancies. There is still a debate about the optimal surgical approach for thymic tumors, particularly regarding long-term oncological outcome. This study aimed to compare videothoracoscopic surgery (VTS) with open surgery for thymic malignancies, regarding perioperative and long-term oncological outcomes. A prospective study ran from 2010 to 2019. Patients with thymoma or thymic carcinoma underwent complete thymectomy via VTS or open surgery and were followed up. The long-term oncological outcome was disease recurrence. There were 29 patients in the VTS group and 35 patients in the open group with an average follow-up period of 80 months. The VTS approach significantly shortened operative duration (89.7 versus 116.9 min), caused less blood loss (56.9 versus 176.3 ml), reduced pain score (4.8 versus 6.7), and shortened chest drainage duration (2.1 versus 3.1 days) as well as hospital stay (5.1 versus 7.7 days). The two groups were comparable in long-term oncological outcome (two recurrences in the VTS group and one in the open group). Compared to open surgery, VTS leads to superior perioperative outcomes and a comparable long-term oncological outcome. The authors advocate the VTS approach as a routine option for the surgery of thymic malignancies. Videothoracoscopic surgery is less traumatic and has faster recovery times than open surgery, with a comparable long-term oncological outcome.