Long-term outcomes of robot versus video-assisted thymectomy for thymic epithelial tumors: a propensity matched analysis

BMC Surg. 2024 Nov 20;24(1):365. doi: 10.1186/s12893-024-02661-3.

Abstract

Background: Robot-assisted thoracoscopic surgery (RATS) thymectomy has been increasingly performed for treating thymic epithelial tumors in recent years. However, there are very limited reports on the long-term oncologic outcomes after RATS thymectomy, particularly in comparison to Video-assisted thoracoscopic surgery (VATS). This study aimed to compare the perioperative and long-term oncological outcomes between RATS and VATS.

Methods: The study was conducted on 180 consecutive patients undergoing RATS or VATS between July 2016 and December 2019, 85 of whom underwent RATS, and 95 of whom underwent VATS. A 1:1 matched propensity score-matched analysis was performed and the perioperative and long-term oncologic outcomes of the two groups compared.

Result: RATS group experienced a shorter operation time (median: 100 min vs. 120 min; P = 0.039) and less blood loss (40.00 ml vs. 50.00 ml, P = 0.011). RATS demonstrated a significantly lower conversion rate to open surgery compared to VATS, with only two patients requiring conversion in the RATS group as opposed to ten patients in the VATS group (3.03% vs. 15.15%, P = 0.030). In the RATS group, the 5-year progression-free survival rate was 87.70%, and the 5-year tumor-related survival rate was 92.31%, demonstrating no statistically significant difference compared to those in the VATS group.

Conclusion: Compared with VATS, robotic thymectomy demonstrated excellent perioperative outcomes, and RATS achieved long-term oncologic outcomes comparable to those of VATS. RATS thymectomy could be considered as an effective alternative approach for treating thymic epithelial tumors.

Keywords: Perioperative outcomes; Robot-assisted thoracoscopic surgery; Survival; Thymic epithelial tumor; Video-assisted thoracoscopic surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms, Glandular and Epithelial* / mortality
  • Neoplasms, Glandular and Epithelial* / pathology
  • Neoplasms, Glandular and Epithelial* / surgery
  • Operative Time
  • Propensity Score*
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Thoracic Surgery, Video-Assisted* / methods
  • Thymectomy* / methods
  • Thymus Neoplasms* / mortality
  • Thymus Neoplasms* / pathology
  • Thymus Neoplasms* / surgery
  • Treatment Outcome

Supplementary concepts

  • Thymic epithelial tumor