Intermediate-Term Oncologic Outcomes Following Single-Incision Video-Assisted Thoracoscopic Thymectomy for Early-Stage Thymoma
Stevan S. Pupovac, MD, Joshua S. Newman, MD, Miguel Alexis, MD, David Zeltsman, MD.
Department of Cardiovascular and Thoracic Surgery, Hofstra Northwell School of Medicine, Queens, NY, USA.
OBJECTIVE: Recent years have seen a trend towards utilizing a video-assisted thoracic surgery (VATS) approach for treatment of early-stage thymoma. Although increasing in utilization, intermediate- and long-term oncological outcome data is lacking for the VATS approach. Further, there is no oncological data for the single-incision VATS technique. We sought to evaluate the feasibility and impact on patient survival of single-incision video assisted thoracic surgery (VATS) thymectomy for early-stage thymoma.
METHODS: The clinical outcomes for 17 patients with Masoaka stage I to II thymomas treated between January of 2009 and July of 2014 at a single institution were collected retrospectively. The primary endpoint was overall survival and secondary endpoint was recurrence-free survival.
RESULTS: Nine women and eight men underwent single-incision VATS thymectomy; ten had stage I thymoma and seven had stage II thymoma. There were no conversions to open surgery. Operative mortality was zero. Mean tumor size was 3.84 ± 0.99 centimeters, with a range of 1.90 to 6.0 centimeters. All patients underwent a R0 resection. Five-year survival was 100%, and the estimated recurrence-free survival was 100%.
CONCLUSIONS: Our findings suggest that single-incision VATS thymectomy for early-stage thymoma is feasible, and the intermediate-term oncological outcomes are comparable to historic standards for open and multi-incision VATS thymectomy. However, additional follow-up is required to evaluate for long-term oncological outcomes.
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