Background/Objectives: Total thymectomy is currently the gold standard operation for treating thymoma. However, recent studies have suggested the potential health consequences of thymus removal in adults, including possible increased autoimmune disease and all-cause mortality. In this context, we assess oncologic outcomes following total vs. partial thymectomy for early-stage thymoma.Methods: We identified patients diagnosed with WHO types A–B3 thymoma between 2010–2021 from a national hospital-based dataset. We excluded patients with stage II or higher disease, open resections and perioperative chemo-/radiation therapy. We stratified patients into total and partial thymectomy cohorts. We used propensity score matching to minimize confounding, Kaplan–Meier analysis to estimate survival, and Cox proportional hazards to identify associations.Results: Of 1598 patients with early-stage thymoma, 495 (31.0%) underwent partial and 1103 (69.0%) total thymectomy. Patients undergoing partial thymectomy were similar in sex (female 53.7% vs. 53.4%;p= 0.914), race (white 74.5% vs. 74.0%;p= 0.921), comorbidities (0 in 77.0% vs. 75.5%;p= 0.742), and tumor size (48.7 mm vs. 50.4 mm;p= 0.455) compared to total thymectomy. There were no differences in 30-day (0.8% vs. 0.6%,p= 0.747) or 90-day mortality (0.8% vs. 0.8%,p> 0.999), which persisted after matching. Moreover, 10-year survival was similar in both unmatched (p= 0.471) and matched cohorts (p= 0.828). Partial thymectomy was not independently associated with survival (aHR = 1.00,p= 0.976).Conclusions: In patients with early-stage thymoma, partial and total thymectomy were associated with similar short- and long-term outcomes. In light of recent attention to the role of the thymus gland, the results add important insights to shared decision-making discussions.
背景/目的：全胸腺切除术目前是治疗胸腺瘤的标准术式。然而，近期研究表明成人胸腺切除可能带来潜在健康风险，包括自身免疫性疾病发病率和全因死亡率的潜在上升。在此背景下，本研究旨在评估早期胸腺瘤患者接受全胸腺切除术与部分胸腺切除术的肿瘤学预后差异。 方法：基于全国医院数据库，我们筛选出2010年至2021年间诊断为WHO分型A-B3型胸腺瘤的患者。排除标准包括：II期及以上疾病、开胸手术及围手术期接受放化疗的患者。将患者分为全胸腺切除组与部分胸腺切除组，采用倾向评分匹配法控制混杂因素，通过Kaplan-Meier法进行生存分析，并运用Cox比例风险模型评估相关性。 结果：在1598例早期胸腺瘤患者中，495例（31.0%）接受部分胸腺切除术，1103例（69.0%）接受全胸腺切除术。两组患者在性别（女性53.7% vs. 53.4%；p=0.914）、种族（白人74.5% vs. 74.0%；p=0.921）、合并症（无合并症者77.0% vs. 75.5%；p=0.742）及肿瘤大小（48.7 mm vs. 50.4 mm；p=0.455）方面具有可比性。30天死亡率（0.8% vs. 0.6%，p=0.747）与90天死亡率（0.8% vs. 0.8%，p>0.999）无统计学差异，匹配后结果保持一致。此外，未匹配队列（p=0.471）与匹配队列（p=0.828）的10年生存率均无显著差异。多因素分析显示部分胸腺切除术并非独立生存影响因素（校正风险比=1.00，p=0.976）。 结论：对于早期胸腺瘤患者，部分胸腺切除术与全胸腺切除术在短期及长期预后方面效果相当。结合近期对胸腺功能的关注，本研究结果为临床决策讨论提供了重要依据。
Minimally Invasive Total Versus Partial Thymectomy for Early-Stage Thymoma
肿瘤(癌症)患者之家