Boston - American Association for Thoracic Surgery

AMERICAN ASSOCIATION FOR THORACIC SURGERY45. Minimally Invasive Resection of Stage 1 and 2 Thymoma:Comparison with Open ResectionArjun Pennathur, Irfan Qureshi, Matthew Schuchert, Peter Ferson, Neil A. Christie,Sebastien Gilbert, William Gooding, Manisha Shende, Rodney J. Landreneau, *James D. Luketich *University of Pittsburgh Medical Center, Pittsburgh, PA, USAInvited Discussant: David JablonsOBJECTIVE: The minimally invasive thoracoscopic (VATS) approach to resectionof the thymus is practiced in benign disease, but a VATS approach for thymomaremains controversial. The objective of this study was to evaluate the results ofVATS thymectomy for the treatment of early stage thymoma and compare theseresults with open resectionMETHODS: A retrospective review of patients undergoing surgical resection ofearly stage thymoma over a 9 year period was conducted. Data on complications,recurrence and survival were collected. The primary endpoint studied was overallsurvival.RESULTS: Thymectomy was performed for 38 patients with Stage I (n = 14) andStage II (n = 24) thymoma. There were 16 men and 22 women (median age 64;range 35–86 years). Open thymectomy was performed in 22 patients, VATS resectionwas performed in 16. Margins of resection were negative in over 90% in bothgroups and the operative mortality was 0%. Stages were equivalent in both surgicalgroups, and there was no significant difference in the number receiving adjuvantradiotherapy for stage II disease. Median length of stay was shorter in the VATSgroup. During follow-up (mean follow-up: 34.8 months) there was one death inthe VATS group at 7. 1 years. Estimated cancer-specific 5-year survival was 100% inboth groups (Table).Comparison of VATS vs. Open Approach for Early Stage ThymomaThoravoscopicApproach (n = 16)OpenApproach (n = 22)p-ValueTUESDAYAfternoonStage I 5 (31.3%) 9 (40.9%) 0.4227Stage II 11 (68.7%) 13 (59.1%) 0.8383R0 Resection 15/16 (93.8%) 20/22 (90.9%) 0.8634Median Length of Stay (Days) 2.5 5 0.0057Recurrence 0/16 (0%) 2/22 (9.1%) NSEstimated Overall 5 Year Survival 100% 100% NSCONCLUSION: VATS resection of early stage thymoma appears safe, with ashorter length of stay. Oncologic outcomes were excellent and equivalent in theopen and VATS groups during intermediate term follow-up. Further follow-up isrequired to evaluate the long term results of thoracoscopic thymectomy for earlystage thymoma.* AATS Member179