WCLC 2025 - Posters & ePosters-P3.14.17 Oncological Outcomes of Complete Versus Limited Thymectomy in Stage I Thymic Epithelial Tumours

Pdf Summary

This individual-patient-data (IPD) meta-analysis evaluated oncological outcomes of complete versus limited thymectomy in patients with stage I thymic epithelial tumors (TETs). Data from 2314 patients (1434 complete thymectomy, 880 limited thymectomy) were pooled from seven studies. The main outcomes assessed were freedom from recurrence (FFR) or time to progression (TTP), depending on study reporting, and recurrence rates were compared with stratification by tumor stage and surgical extent.<br /><br />The analysis found no significant difference in recurrence-free survival between complete and limited thymectomy overall (hazard ratio [HR] 0.87). However, when limited thymectomy was subdivided, subtotal thymectomy had better FFR than thymomectomy alone. Recurrence rates were slightly higher after limited thymectomy (4.4%) than complete thymectomy (3.2%). Notably, in Masaoka-Koga stage II disease, limited thymectomy was associated with a significantly increased recurrence risk compared to complete resection (odds ratio [OR] 2.94; p=0.02).<br /><br />The findings indicate no evidence favoring limited thymectomy over complete thymectomy for early-stage TETs, and suggest a potential oncological disadvantage with limited surgery, especially in stage II tumors. Among limited thymectomy approaches, more extensive resection (subtotal thymectomy) may confer better outcomes than thymomectomy alone. The study supports complete thymectomy as the preferred surgical approach in early-stage thymic tumors to minimize recurrence risk.<br /><br />The analysis included contributions from several thoracic surgery and oncology centers in Italy and Canada. Reference studies ranged from 2014 to 2024. Overall, this large-scale IPD meta-analysis provides evidence guiding surgical strategy for thymic epithelial tumors, emphasizing the importance of complete thymectomy for optimal oncological outcomes.

Asset Subtitle

Riccardo Taje'

Meta Tag

Speaker Riccardo Taje'

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

individual-patient-data meta-analysis

thymectomy

thymic epithelial tumors

stage I thymic tumors

complete thymectomy

limited thymectomy

recurrence-free survival

subtotal thymectomy

Masaoka-Koga stage II

oncological outcomes