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Determinants of complete resection of thymoma by minimally invasive and open thymectomy: analysis of an international registry

Phase observationalN = 2,514

Population
2,514 patients who underwent thymectomy for thymoma, 1997-2012
Design
Retrospective analysis of the International Thymic Malignancy Interest Group (ITMIG) database: 2,514 patients who underwent thymectomy for thymoma between 1997 and 2012, 2,053 (82%) by open thymectomy and 461 (18%) by minimally invasive thymectomy. Chi-square and Wilcoxon rank-sum tests, multivariate logistic regression and propensity matching (266 patients in each matched group). Not randomised. On multivariate analysis, surgical approach was not associated with completeness of resection; factors associated with R0 resection were geographical region, later time period, less advanced Masaoka stage, total thymectomy and absence of radiotherapy. In the full text, the minimally invasive group had smaller tumours (mean 4.0 versus 6.0 cm), less advanced pathological Masaoka stage and more favourable WHO histology, and partial thymectomy was more frequent (27% versus 9%); among the minimally invasive operations 315 were thoracoscopic and 146 robotic; survival was not analysed and the authors state that recurrence events were too few to study recurrence.
Arms
  • Open thymectomy (control, n = 2,053): Open thymectomy
  • Minimally invasive thymectomy (experimental, n = 461): Minimally invasive thymectomy
People
Burt BM, senior author Scott W, International Thymic Malignancy Interest Group (ITMIG)
Δ R0 resection+8 pointsΔ R0 resection0 points
Show the numbers
Results reported for Determinants of complete resection of thymoma by minimally invasive and open thymectomy: analysis of an international registry
EndpointAnalysisMinimally invasive thymectomyOpen thymectomyEffect
R0 resectionAll 2,514 patients (unmatched)finalBurt 201794%86%P<0.0001Observational, unadjusted comparison.
R0 resectionPropensity-matched groups (266 patients in each group)finalBurt 201796%96%P=0.7Observational; matched on recorded characteristics only.
Results reported for Determinants of complete resection of thymoma by minimally invasive and open thymectomy: analysis of an international registry
EndpointAnalysisMinimally invasive thymectomyOpen thymectomyEffect
R0 resectionAll 2,514 patients (unmatched)finalBurt 201794%86%P<0.0001Observational, unadjusted comparison.
R0 resectionPropensity-matched groups (266 patients in each group)finalBurt 201796%96%P=0.7Observational; matched on recorded characteristics only.
Primary publication: Burt BM, Yao X, Shrager J, Antonicelli A, Padda S, Reiss J, et al. Determinants of Complete Resection of Thymoma by Minimally Invasive and Open Thymectomy: Analysis of an International Registry. J Thorac Oncol. 2017;12(1):129-136. PubMedDOI

Appears in

Sources

  1. Burt BM, Yao X, Shrager J, Antonicelli A, Padda S, Reiss J, et al. Determinants of Complete Resection of Thymoma by Minimally Invasive and Open Thymectomy: Analysis of an International Registry. J Thorac Oncol. 2017;12(1):129-136.

    PubMedDOI