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Zhongguo Fei Ai Za Zhi. 2016 Jul 20;19(7):453-8. doi: 10.3779/j.issn.1009-3419.2016.07.07.

[Perioperative Outcomes and Long-term Survival in Clinically Early-stage Thymic 
Malignancies: Video-assisted Thoracoscopic Thymectomy versus Open Approaches].

[Article in Chinese; Abstract available in Chinese from the publisher]

Author information

Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
Department of Thoracic Surgery, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China.
Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao 266001, China.
Department of Endocrinology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu 610041, China.
Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Department of Thoracic Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Department of Thoracic Surgery, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
Department of Thoracic Surgery, Beijing Cancer Hospital, Beijing 100142, China.
Department of Cardiothoracic Surgery, Changhai Hospital, Shanghai 200433, China.
Department of Thoracic Surgery, Liaoning Cancer Hospital, Shenyang 110042, China.
Department of Thoracic Surgery, First Affiliated Hospital of Jilin University, Changchun 130021, China.
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Thoracic Surgery, Huashan Hospital, Fudan University, Shanghai 200032, China.
Department of Esophageal Cancer, Tianjin Cancer Hospital, Tianjin 300060, China.
Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China.
Department of Thoracic Surgery, Jiangxi People's Hospital, Nanchang 330006, China.


in English, Chinese


Video-assisted thoracoscopic surgery (VATS) theoretically offers advantages over open thymectomy for clinically early-stage (Masaoka-Koga stage I and II) thymic malignancies. However, longterm outcomes have not been well studied. We compared the postoperative outcomes and survival from a cohort study based on the database of the Chinese Alliance for Research in Thymomas (ChART).


Between 1994 and 2012, data of 1,117 patients having surgery for clinically early-stage (Masaoka-Koga stage I and II) tumors were enrolled for the study. Among them, 241 cases underwent VATS thymectomy (VATS group), while 876 cases underwent open thymectomy (Open group). Univariate analyses were used to compare the clinical character and perioperative outcomes between the two groups. And multivariate analysis was performed to determine the independent predictive factors for long-term survival.


Compared with the Open group, the VATS group had higher percentage of total thymectomy (80.5% vs 73.9%, P=0.028), resection rate (98.8% vs 88.7%, P<0.001) and less recurrence (2.9% vs 16.0%, P<0.001). Five-year overall survival was 92% after VATS and 92% after open thymectomy, with no significant difference between the two groups (P=0.15). However, 5-year disease free survival were 92% in VATS group and 83% in Open group (P=0.011). Cox proportional hazards model revealed that WHO classification, Masaoka-Koga stage and adjuvant therapy were independent predictive factors for overall survival, while surgical approach had no significant impact on long-term outcome.


This study suggests that VATS thymectomy is an effective approach for clinically early-stage thymic malignancies. And it may offer better perioperative outcomes, as well as equal oncological survival.

[Indexed for MEDLINE]
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