Comparison of Oncological Outcomes After Partial and Total Thymectomy For Stage I Thymomas.
Publication Title
The Annals of thoracic surgery
Document Type
Article
Publication Date
11-24-2025
Keywords
washington; swedish; swedish cancer; swedish thoracic surgery
Abstract
BACKGROUND: Total thymectomy (TT) has been the standard treatment for thymoma. However, many thymomas may be amenable to partial thymectomy (PT), which can achieve similar R0 resection frequency with favorable perioperative outcomes. We sought to determine if PT results in similar oncological outcomes to TT for non-invasive thymomas.
METHODS: We queried the International Thymic Malignancy Interest Group retrospective database from 2000-2014 for patients with stage I thymomas without myasthenia gravis undergoing TT or PT. Outcomes were freedom from recurrence (weighted for age and T category [1a vs 1b]) and overall survival with inverse probability weights of patient factors as predictors of TT.
RESULTS: A total of 692 patients were included with 158 PT (23%) and 534 TT (77%). PT were younger with better performance status. R0 resection and histology were similar. The PT group had more T1b thymomas. Adjuvant chemotherapy and radiation were more frequent after PT. There was no difference in new-onset myasthenia gravis. Weighted freedom from recurrence (Hazard ratio: 1.09, p=0.81 and overall survival (Hazard ratio: 0.62, p=0.11) was similar for PT compared to TT.
CONCLUSIONS: PT for stage I thymomas without myasthenia resulted in statistically similar recurrence and survival, and no difference in the development of new-onset myasthenia gravis , compared to TT. These results add to a growing body of literature around PT, suggesting it may be considered for Stage I thymomas when R0 resection can reasonably be achieved. Surgeons performing PT are encouraged to report their outcomes to continue this discussion.
Area of Special Interest
Cancer
Specialty/Research Institute
Swedish Thoracic Surgery
Specialty/Research Institute
Oncology
Specialty/Research Institute
Surgery
DOI
10.1016/j.athoracsur.2025.11.016
