Thoracoscopic Thymectomy Is A Feasible And Less Invasive Alternative For The Surgical Treatment Of Large Thymomas

OBJECTIVES: Thoracoscopic surgery is widely used for the surgical treatment of thymoma. However, large-sized thymomas are typically treated using open surgery. This study evaluated the feasibility of performing thoracoscopic thymectomy (TT) for thymoma >= 50 mm.METHODS: A retrospective review was conducted on 135 patients who underwent TT or open thymectomy (OT) for Masaoka stage I-IVa thymoma between 1996 and 2014.RESULTS: Patients were first divided into two groups based on thymoma size: thymoma >= 50mm and thymoma <50mm groups. There was no significant difference in the 5-year disease-free survival (DFS) between the groups (P = 0.5352). Patients in the thymoma >= 50mm group were further subdivided into TT and OT groups. The length of postoperative hospital stay was significantly shorter in the TT group than in the OT group (5 vs 14 days, P < 0.0001), with significantly fewer postoperative complications (6 patients vs 14 patients, P = 0.0008). There was no significant difference in the 5-year DFS between patients with thymoma >= 50mm in the TT and OT groups (P = 0.3501). Finally, patients undergoing TT were further subdivided into thymoma >= 50mm and thymoma <50mm groups and, no significant difference in the 5-year DFS was found between these groups (P = 0.6661). Masaoka stages III-IV, but not thymoma size, were an independent prognostic factor for DFS.CONCLUSIONS: These results demonstrate the decreased invasiveness and feasibility of TT for large-sized thymomas.