Thymic tumours: a single center surgical experience and literature review on the current diagnosis and management of thymic malignancies

Minervini, Fabrizio; Boschetti, Laura; Gregor, Michael; Provencio, Mariano; Calvo, Virginia; Kestenholz, Peter; Lampridis, Savvas; Patrini, Davide; Bertoglio, Pietro; Azenha, Luís Filipe; Sergi, Consolato; Kocher, Gregor J.

doi:10.21037/gs-21-517

Cited by 2 publications

(2 citation statements)

References 82 publications

(86 reference statements)

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“…[7]. С этого момента использование однопортовой техники прочно заняло свое место в практике торакальных хирургов и в настоящий момент выполняется весь спектр операций с использованием данного доступа [8][9][10][11][12][13][14][15][16][17][18]. Однако применительно к тимэктомиям сведений об использовании однопортового доступа недостаточно.…”

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Comparative analysis of the immediate results of thoracoscopic thymectomy using single-port and three-port approaches in the treatment of non-invasive epithelial thymic tumors

Epifantsev,

Smirnov,

Gritsun

et al. 2023

Issled. prakt. med. (Print)

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Purpose of the study. Evaluation of the safety and effectiveness of single-port thoracoscopic thymectomy in comparison with traditional three-port thymectomy in patients with stage I and II thymic epithelial tumors.Patients and methods. The results of 50 thoracoscopic thymectomies performed from January 2019 to May 2023 on patients with stage I and II thymic epithelial tumors without the presence of myasthenia were analyzed. The age of the patients ranged from 20 to 75 years, with a median of 44 years. There were 28 (56 %) women, 22 (44 %) men. The minimum size of the removed thymoma in the study was 20 mm, the maximum was 165 mm. Out of the 50 patients who underwent singleand three-port thoracoscopic thymectomy, 42 (84 %) had tumor diameters of 70 mm or less, and 8 (16 %) had tumor diameters greater than 70 mm. Tumor size was significantly larger in the three-port thymectomy group (43 mm [35 mm; 55 mm] vs. 60 mm [38 mm; 78 mm], p = 0.044).Results. The analysis noted a statistically significant increase in the duration of the operation in the group of three-port thoracoscopic thymectomies (duration of operations – 107.5 minutes [70 minutes; 132.5 minutes] versus 70.0 minutes [57 minutes; 79 minutes] in the group with a single-port approach). A statically significant result was also obtained in terms of drainage of pleural cavity drainage and, as a consequence, in duration of postoperative bed rest. Patients operated through a single-port approach stayed in the hospital for 3 to 5 days on average (4.0 days), while those with a three-port approach stayed from 3 to 13 days on average (5.0 days). A comparative analysis revealed a significant reduction in the length of hospital stay in patients who underwent single-port thoracoscopic thymectomy, in contrast to those undergoing three-port surgical interventions.Conclusion. This study is the first in Russia to compare oneand three-port techniques for removing thymic tumors in a number of patients sufficient for statistical calculations. It has been shown that for thymic tumors up to 5 cm, single-port thoracoscopic thymectomy compared to three-port does not lead to prolongation of the operation or an increase in intraand postoperative complications. Therefore, in our opinion, it is the preferable option.

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Section: Discussionunclassified

Comparative analysis of the immediate results of thoracoscopic thymectomy using single-port and three-port approaches in the treatment of non-invasive epithelial thymic tumors

Epifantsev,

Smirnov,

Gritsun

et al. 2023

Issled. prakt. med. (Print)

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“…Thymic tumors are rare neoplasms that arise from the anterior mediastinum. Most of them are thymic epithelial carcinomas (TETs) 1,2 . The 5th edition of the “WHO Classification of Thoracic Tumors” continues to use the “type A, AB, B1‐B3 thymoma” and thymic carcinoma for TETs, based on pathological results 3,4 .…”

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confidence: 99%

Multiparametric Magnetic Resonance Imaging for Assessing Thymic Epithelial Tumors: Correlation With Pathological Subtypes and Clinical Stages

Shen

Zhang

Zhu

et al. 2022

Magnetic Resonance Imaging

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Background World Health Organization classification and Masaoka‐Koga stage are widely used for thymic epithelial tumors (TETs). Reduced field‐of‐view (rFOV) diffusion‐weighed imaging (DWI) proved to improve the image quality. Dynamic contrast‐enhanced (DCE) MRI was commonly used in evaluating tumors. Purpose To investigate the value of multiparametric MRI in evaluating TETs. Study Type Retrospective. Subjects Eighty‐seven participants including 38 low risk (52.08 ± 14.19 years), 30 high risk (52.40 ± 11.35 years), and 19 thymic carcinoma patients (59.76 ± 10.78 years). Field strength/Sequence A 3 T, turbo spin echo imaging, echo planar imaging, volumetric interpolated breath‐hold examination with radial acquisition trajectory. Assessment DCE‐MRI and apparent diffusion coefficient (ADC) variables were compared. Diagnostic performances of single significant factor and combined model were compared. Statistical Tests Parameters were compared using one‐way ANOVA or independent‐samples t test. Logistic regression was employed to investigate the combined model. Receiver operating curves (ROC) and DeLong's test were used to compare the diagnostic efficiency. Results ADC, Ktrans, and kep values were significantly different among low‐risk, high‐risk and carcinoma group (ADC, 1.279 ± 0.345 × 10−3 mm2/sec, 0.978 ± 0.260 × 10−3 mm2/sec, 0.661 ± 0.134 × 10−3 mm2/sec; Ktrans 0.167 ± 0.071 min−1, 0.254 ± 0.136 min−1, 0.393 ± 0.110 min−1; kep 0.345 ± 0.113 min−1, 0.560 ± 0.269 min−1, 0.872 ± 0.149 min−1). They were significantly different for early stage and advanced stage (ADC, 1.270 ± 0.356 × 10−3 mm2/sec vs. 0.845 ± 0.251 × 10−3 mm2/sec; Ktrans 0.179 ± 0.092 min−1 vs. 0.304 ± 0.142 min−1; kep 0.370 ± 0.181 min−1 vs. 0.674 ± 0.362 min−1). The combination of them had highest diagnostic efficiency for WHO classification (AUC, 0.925; sensitivity, 83.7%; specificity, 89.5%), clinical stage (AUC, 0.879; sensitivity, 80.9%; specificity, 82.5%). Data Conclusion Multiparametric MRI model may be useful for discriminating WHO classification and clinical stage of TETs. Evidence Level 4 Technical Efficiency Stage 2

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Thymic tumours: a single center surgical experience and literature review on the current diagnosis and management of thymic malignancies

Cited by 2 publications

References 82 publications

Comparative analysis of the immediate results of thoracoscopic thymectomy using single-port and three-port approaches in the treatment of non-invasive epithelial thymic tumors

Comparative analysis of the immediate results of thoracoscopic thymectomy using single-port and three-port approaches in the treatment of non-invasive epithelial thymic tumors

Multiparametric Magnetic Resonance Imaging for Assessing Thymic Epithelial Tumors: Correlation With Pathological Subtypes and Clinical Stages

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