Safety Analysis of Superior Vena Cava Resection for Extended Thymic Epithelial Neoplasms>

Abstract

Background: infiltration of superior vena cava (SVC) is not rare. The extent of SVC resection depends on the width of the area of neoplastic invasion. Aims: To evaluate the safety of extended thymectomy for Thymic Epithelial Neoplasm (TEN) with SVC resection. Methods: Retrospectively review of thymectomy for TEN in the last twenty years according to STROBE methodology. Disease-free survival (DFS) and overall survival (OS) were calculated using the Kaplan – Meier method. A backward stepwise Cox regression multivariate analysis was performed to determine factors associated with long-term outcomes. Results: 78 patients underwent surgery for advanced-stage TEN (1998 - 2019). 17.9% underwent thymectomy with resection of SVC. Thymic carcinoma was a negative prognostic factor (HR = 2.26; 95% CI = 1.82 – 6.18; p = 0.038) at the multivariate analysis. The median OS and the DFS of SVC resected patients were 50 months (range: 5 – 207) and 31 months (range: 5 – 151). There was no significant difference in OS and DFS between SVC resected and not resected patients. Conclusions: SVC resection is a safe and effective procedure and does not seem to affect survival and disease recurrence. This surgical approach is oncologically reliable to allow radical resection of locally advanced TEN.