초록접수 현황
| 19F-195 | 구연 발표 |
Surgical Approach for the Treatment of Thymic Carcinoma: Result of 201 Cases from a Korean Multi-Institutional Database Study
Yeong Jeong Jeon¹, Yong Soo Choi¹, Jong Ho Cho¹, Hong Kwan Kim¹, Geun Dong Lee², Dong Kwan Kim², Chang Hyun Kang³, Young Tae Kim³, Chang Young Lee⁴, Jin Gu Lee⁴
¹Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, ²Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea,³Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea, ⁴Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : This study aimed to compare the outcomes of surgical approach (VATS vs sternotomy vs thoracotomy) for the treatment of thymic carcinoma.
Methods : We retrospectively reviewed 201 patients with pathologically proven thymic carcinoma who underwent surgical resection at 4 Korean institutions.
Results : From 2007 to 2013, 158 sternotomy, 33 VATS and 10 thoracotomy were conducted for thymic carcinoma. Open group underwent more preoperative biopsy (41.8% and 50% vs 15.2%, p=0.012) and neoadjuvant treatment (22.2% and 30% vs 0%, p=0.008) than VATS group. In preoperative imaging, tumor size of VATS group was smaller than sternotomy group (3.8±1.1 vs 5.8±2 cm, p<0.05) and 91% of the VATS group was clinical TNM stage I. In VATS group, the operation time was shorter and blood loss was lesser than open group (p<0.001). Eighty-five percent of sternotomy group underwent total thymectomy while 58% of VATS group underwent thymomectomy. Eighty-five percent of open group underwent resection of surrounding tissues. The duration of chest tube and mechanical ventilation, postoperative hospital day and ICU stay were shorter in VATS group than open group (p<0.001). The incidence of postoperative complications of VATS group was lower than sternotomy group (p=0.014). The 5-year overall survival of the VATS, sternotomy, and thoracotomy group were 100%, 100% and 87.5±11.7%, respectively (p=0.107). The 5-year recurrence-free survival rate was not different between the groups (67.9±12.1%, 55.4±4.5%, and 87.5±11.7%, p=0.131)
Conclusion : The VATS approach of surgical treatment for thymic carcinoma can be selectively employed in small (<5cm) and TNM stage I tumor without compromise of oncologic outcomes.
Methods : We retrospectively reviewed 201 patients with pathologically proven thymic carcinoma who underwent surgical resection at 4 Korean institutions.
Results : From 2007 to 2013, 158 sternotomy, 33 VATS and 10 thoracotomy were conducted for thymic carcinoma. Open group underwent more preoperative biopsy (41.8% and 50% vs 15.2%, p=0.012) and neoadjuvant treatment (22.2% and 30% vs 0%, p=0.008) than VATS group. In preoperative imaging, tumor size of VATS group was smaller than sternotomy group (3.8±1.1 vs 5.8±2 cm, p<0.05) and 91% of the VATS group was clinical TNM stage I. In VATS group, the operation time was shorter and blood loss was lesser than open group (p<0.001). Eighty-five percent of sternotomy group underwent total thymectomy while 58% of VATS group underwent thymomectomy. Eighty-five percent of open group underwent resection of surrounding tissues. The duration of chest tube and mechanical ventilation, postoperative hospital day and ICU stay were shorter in VATS group than open group (p<0.001). The incidence of postoperative complications of VATS group was lower than sternotomy group (p=0.014). The 5-year overall survival of the VATS, sternotomy, and thoracotomy group were 100%, 100% and 87.5±11.7%, respectively (p=0.107). The 5-year recurrence-free survival rate was not different between the groups (67.9±12.1%, 55.4±4.5%, and 87.5±11.7%, p=0.131)
Conclusion : The VATS approach of surgical treatment for thymic carcinoma can be selectively employed in small (<5cm) and TNM stage I tumor without compromise of oncologic outcomes.
책임저자: Yong Soo Choi
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Yeong Jeong Jeon, E-mail : yj.yj.jeon@samsung.com