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The following is a summary of “Robotic-assisted Extended Thymectomy for Large Resectable Thymoma: 21 Years’ Experience,” published in the August 2024 issue of Surgery by Huang et al.

This study aimed to comprehensively assess the perioperative and midterm oncological outcomes of robotic-assisted thoracic surgery (RATS) extended thymectomy in patients with large resectable thymomas, comparing these results with outcomes in patients with small thymomas. As a retrospective single-center analysis, the study included 204 patients who underwent RATS extended thymectomy between January 2003 and February 2024. Patients were categorized into two groups based on thymoma size, using a 5 cm threshold to distinguish between small thymomas (ST) and large thymomas (LT). Of the total patient population, 114 (55.9%) had small thymomas, while 90 (44.1%) had large thymomas. The study found no significant differences between the two groups regarding demographic factors such as gender, age, or the proportion of elderly patients, nor in pathologic high-risk classifications. The primary distinction noted was a longer operative time in the LT group (p=0.009), although other surgical parameters and postoperative outcomes were similar across both groups. Notably, neither group had any deaths within the first 30 days post-surgery. With a median follow-up period of 61.0 months (95% CI: 48.96-73.04), the recurrence rate was low, with only four patients (1.96%) experiencing recurrence. 

Furthermore, the study revealed no significant differences in the five-year overall survival (OS) rate (p=0.25) or recurrence-free survival (RFS) rate (p=0.43) between patients with small and large thymomas. These findings suggest that RATS extended thymectomy is a technically feasible, safe, and effective surgical approach for treating large resectable thymomas. Moreover, the midterm oncological outcomes for patients with completely resected large thymomas are comparable to those with small thymomas, indicating that size does not negatively impact survival or recurrence rates during the median five-year follow-up period. This study underscores the efficacy of RATS in managing thymomas of varying sizes, supporting its continued use in thoracic surgery for thymoma resection.

Source: sciencedirect.com/science/article/pii/S0022522324006895