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An Overview of Surgical Treatment of Thymic Epithelial Tumors in Korea: A Retrospective Multicenter Analysis

  • Lee, Jun Oh (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine) ;
  • Lee, Geun Dong (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine) ;
  • Kim, Hyeong Ryul (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine) ;
  • Kim, Dong Kwan (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine) ;
  • Park, Seung-Il (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine) ;
  • Cho, Jong Ho (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Hong Kwan (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Yong Soo (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Jhingook (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Shim, Young Mog (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Samina (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Park, In Kyu (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kang, Chang Hyun (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Young Tae (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Park, Seong Yong (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Chang Young (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Jin Gu (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Dae Joon (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • Paik, Hyo Chae (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • the Korean Association for Research on the Thymus, (the Korean Association for Research on the Thymus)
  • Received : 2021.10.05
  • Accepted : 2022.01.12
  • Published : 2022.04.05

Abstract

Background: Thymic epithelial tumors (TETs) are rare, and information regarding their surgical outcomes and prognostic factors has rapidly changed in the past few decades. We analyzed surgical treatment practices for TETs and outcomes in terms of overall survival (OS) and freedom from recurrence (FFR) during a 13-year period in Korea. Methods: In total, 1,298 patients with surgically resected TETs between 2000 and 2013 were enrolled retrospectively. OS and FFR were calculated using the Kaplan-Meier method and evaluated with the log-rank test. Prognostic factors for OS and FFR were analyzed with multivariable Cox regression. Results: A total of 1,098 patients were diagnosed with thymoma, and 200 patients were diagnosed with thymic carcinoma. Over the study period, the total number of patients with surgically treated TETs and the proportion of patients who underwent minimally invasive thymic surgery (MITS) increased annually. The 5-year and 10-year survival rates of surgically treated TETs were 91.0% and 82.1%, respectively. The 5-year and 10-year recurrence rates were 86.3% and 80.0%, respectively. The outcomes of surgically treated TETs improved over time. Multivariable Cox hazards analysis for OS, age, tumor size, and Masaoka-Koga stage were independent predictors of prognosis. The World Health Organization classification and tumor-node-metastasis (TNM) staging were also related to the prognosis of TETs. Conclusion: Surgical treatment of TETs achieved a good prognosis with a recent increase in MITS. The M-K stage was the most important prognostic factor for OS and FFR. The new TNM stage could also be an effective predictor of the outcomes of TETs.

Keywords

Acknowledgement

Members of the KART Study Group: Geun Dong Lee, Jae Kwang Yun, Sehoon Choi, Hyeong Ryul Kim, YongHee Kim, Dong Kwan Kim, Seung-Il Park (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea); Sumin Shin, Jong Ho Cho, Hong Kwan Kim, Jhingook Kim, Young Mog Shim (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea); Samina Park, In Kyu Park, Chang Hyun Kang, Young Tae Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea); and Chang Young Lee, Jin Gu Lee, Dae Joon Kim, Hyo Chae Paik (Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea).

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