Long-term outcomes of robot-assisted radical thymectomy for large thymomas: A propensity matched analysis.

Abstract

The aim of this study was to evaluate the long-term results of robot-assisted (RATS) thymectomy in the treatment of large thymomas, defined as larger than 5cm. We retrospectively reviewed 106 thymectomies from 2010 to 2020, creating two groups based on the surgical approach (open or RATS) and size. Kaplan-Meier and Cox-regression were used to estimate and identify risk factors of oncological outcomes. To perform a well-balanced analysis, a propensity score matched (PSM) analysis was conducted for large thymomas. From 2015, we performed 54 RATS thymectomies: 53.7% (n=29) for small and 46.3% (n=25) for large thymomas. Conversions were similar and all patients had a complete resection. The overall (82% vs. 92%, p=0.57) and disease-free survival were comparable between RATS and open (92.5% vs. 93%, p=0.67), outcomes confirmed after PSM for large thymomas. RATS thymectomy could be considered a valid option in selected patients with large thymomas.