Abstract:
Background Complete thymectomy has classically been regarded as the standard treatment protocol for thymoma. However, several authors have pointed out that the optimal mode of resection for thymoma in early-stage patients without myasthenia gravis is still controversial, one of the debates is that thymomectomy may be an alternative treatment option.
Objective To compare the perioperative outcomes, survival, and recurrence between patients undergoing thymectomy versus thymomectomy.
Methods From January 2010 to December 2019, clinical data about 321 non-myasthenic patients underwent surgery for stage Ⅰ and Ⅱ thymomas in the First Medical Center of Chinese PLA General Hospital were retrospectively analyzed. Patients were divided into thymomectomy group (n=116) and thymectomy group (n=205). The two groups were matched by propensity score matching to balance the covariates. Surgical and oncologic outcomes were compared.
Results After propensity score matching (PSM), 101 patients in each group were included in the study. The thymomectomy group included 53 males and 48 females, with an average age of 52.2 years old; the thymectomy group included 47 males and 54 females, with an average age of 51.6 years old. The operation time of the thymomectomy group was significantly shorter than that of the thymectomy group (97 min vs 120 min, P<0.001). There was no significant difference in other perioperative outcomes (P>0.05). The 10-year freedom from recurrence (FFR) rate and disease-free survival (DFS) rate of the thymomectomy group were 97.7%, 96.1%, respectively, and they were 96.3% and 91.8% in the thymectomy group, indicating no significant difference between the two groups (P>0.05, respectively).
Conclusion Thymomectomy is not inferior to thymectomy with respect to oncological outcomes, but it has better perioperative outcomes, suggesting that it may be a viable treatment option for early stage thymoma.
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