Work-in-progress report: a prospective, multi-institutional observational study on intraoperative lymph node...

Area of Science:

• Oncology
• Thoracic Surgery
• Surgical Pathology

Background:

• Lymph node metastasis is a poor prognostic factor in thymic epithelial malignancies.
• Current guidelines offer inconsistent recommendations for intraoperative lymph node dissection (LND).
• This study addresses the variability in LND guidelines for thymic malignancies.

Purpose of the Study:

• To evaluate the feasibility and characteristics of intraoperative lymph node dissection (LND).
• To assess LND in patients with resectable thymic epithelial malignancies exhibiting invasive features.
• To compare LND outcomes between open and minimally invasive surgical approaches.

Main Methods:

• Prospective, multi-institutional observational study.
• Inclusion criteria: resectable thymic epithelial malignancies with radiological invasive features (e.g., size >5 cm, SUV >5, suspected invasion).
• All patients underwent complete resection with N1 and/or N2 LND via open or minimally invasive surgery.

Main Results:

• 25 patients were enrolled; all had complete resection with N1/N2 LND.
• 88% underwent N1 LND, and 80% underwent N2 LND.
• No significant differences in dissected stations or N1/N2 LND between open and minimally invasive approaches (P > 0.05).

Conclusions:

• Intraoperative lymph node dissection (LND) appears feasible using both open and minimally invasive techniques.
• LND can contribute to accurate nodal staging in thymic malignancies with invasive features.
• Further research may refine LND protocols for thymic cancers.