Surgical and Oncological Outcomes in Locally Advanced Thymoma

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Oncology

Background:

• Locally advanced thymoma (Masaoka stages III and IVA) presents significant surgical challenges.
• Optimal management strategies for these advanced stages require careful evaluation.

Purpose of the Study:

• To report the surgical management of locally advanced thymoma (Masaoka stages III and IVA).
• To identify factors predicting patient survival after surgery for advanced thymoma.

Main Methods:

• Retrospective analysis of 54 patients with Masaoka stage III or IVA thymoma operated between March 2012 and December 2019.
• Analysis of perioperative variables, complications, and survival predictors using log-rank test.
• Assessment of prognostic factors including age, histology, and extent of resection.

Main Results:

• 5-year overall survival (OS) and disease-free survival (DFS) were 77.8% and 75.9%, respectively.
• Complete (R0) resection was achieved in 87% of cases, with no perioperative deaths.
• Poor prognostic factors included higher age (>60 years), incomplete resection, type B histology, and resection of >3 structures.

Conclusions:

• An aggressive surgical approach by an experienced multidisciplinary team is vital for locally advanced thymoma.
• Complete surgical resection is critical for achieving excellent oncological outcomes and improving survival.
• Careful patient selection and surgical planning can lead to favorable results even in advanced thymoma cases.