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A national analysis of open versus minimally invasive thymectomy for stage I to III thymoma.

Publication ,  Journal Article
Yang, C-FJ; Hurd, J; Shah, SA; Liou, D; Wang, H; Backhus, LM; Lui, NS; D'Amico, TA; Shrager, JB; Berry, MF
Published in: J Thorac Cardiovasc Surg
August 2020

OBJECTIVE: The oncologic efficacy of minimally invasive thymectomy for thymoma is not well characterized. We compared short-term outcomes and overall survival between open and minimally invasive (video-assisted thoracoscopic and robotic) approaches using the National Cancer Data Base. METHODS: Perioperative outcomes and survival of patients who underwent open versus minimally invasive thymectomy for clinical stage I to III thymoma from 2010 to 2014 in the National Cancer Data Base were evaluated using multivariable Cox proportional hazards modeling and propensity score-matched analysis. Predictors of minimally invasive use were evaluated using multivariable logistic regression. Outcomes of surgical approach were evaluated using an intent-to-treat analysis. RESULTS: Of the 1223 thymectomies that were evaluated, 317 (26%) were performed minimally invasively (141 video-assisted thoracoscopic and 176 robotic). The minimally invasive group had a shorter median length of stay when compared with the open group (3 [2-4] days vs 4 [3-6] days, P < .001). In a propensity score-matched analysis of 185 open and 185 minimally invasive (video-assisted thoracoscopic + robotic) thymectomy, the minimally invasive group continued to have a shorter median length of stay (3 vs 4 days, P < .01) but did not have significant differences in margin positivity (P = .84), 30-day readmission (P = .28), 30-day mortality (P = .60), and 5-year survival (89.4% vs 81.6%, P = .20) when compared with the open group. CONCLUSIONS: In this national analysis, minimally invasive thymectomy was associated with shorter length of stay and was not associated with increased margin positivity, perioperative mortality, 30-day readmission rate, or reduced overall survival when compared with open thymectomy.

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Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

August 2020

Volume

160

Issue

2

Start / End Page

555 / 567.e15

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Thymus Neoplasms
  • Thymoma
  • Thymectomy
  • Thoracic Surgery, Video-Assisted
  • Robotic Surgical Procedures
  • Risk Factors
  • Risk Assessment
 

Citation

APA
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MLA
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Yang, C.-F., Hurd, J., Shah, S. A., Liou, D., Wang, H., Backhus, L. M., … Berry, M. F. (2020). A national analysis of open versus minimally invasive thymectomy for stage I to III thymoma. J Thorac Cardiovasc Surg, 160(2), 555-567.e15. https://doi.org/10.1016/j.jtcvs.2019.11.114
Yang, Chi-Fu Jeffrey, Jacob Hurd, Shivani A. Shah, Douglas Liou, Hanghang Wang, Leah M. Backhus, Natalie S. Lui, Thomas A. D’Amico, Joseph B. Shrager, and Mark F. Berry. “A national analysis of open versus minimally invasive thymectomy for stage I to III thymoma.J Thorac Cardiovasc Surg 160, no. 2 (August 2020): 555-567.e15. https://doi.org/10.1016/j.jtcvs.2019.11.114.
Yang C-FJ, Hurd J, Shah SA, Liou D, Wang H, Backhus LM, et al. A national analysis of open versus minimally invasive thymectomy for stage I to III thymoma. J Thorac Cardiovasc Surg. 2020 Aug;160(2):555-567.e15.
Yang, Chi-Fu Jeffrey, et al. “A national analysis of open versus minimally invasive thymectomy for stage I to III thymoma.J Thorac Cardiovasc Surg, vol. 160, no. 2, Aug. 2020, pp. 555-567.e15. Pubmed, doi:10.1016/j.jtcvs.2019.11.114.
Yang C-FJ, Hurd J, Shah SA, Liou D, Wang H, Backhus LM, Lui NS, D’Amico TA, Shrager JB, Berry MF. A national analysis of open versus minimally invasive thymectomy for stage I to III thymoma. J Thorac Cardiovasc Surg. 2020 Aug;160(2):555-567.e15.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

August 2020

Volume

160

Issue

2

Start / End Page

555 / 567.e15

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Thymus Neoplasms
  • Thymoma
  • Thymectomy
  • Thoracic Surgery, Video-Assisted
  • Robotic Surgical Procedures
  • Risk Factors
  • Risk Assessment