Abstract
Background: The Maastricht University Medical Center+ is a Dutch center of expertise appointed by the Netherlands Federation of University Medical Centers for the treatment of thymomas. The aim of this study was to investigate the long-term oncologic, surgical, and neurologic outcomes of all patients who underwent a robotic thymectomy for a thymoma at Maastricht University Medical Center+. Methods: We retrospectively analyzed the clinical-pathologic data of all consecutive patients with a thymoma who underwent robotic thymectomy using the DaVinci robotic system at Maastricht University Medical Center+ between April 2004 and December 2018. Follow-up data were collected from 60 referring Dutch hospitals. Results: In total, 398 robotic thymectomies were performed, and 130 thymomas (32.7%) were found. Median follow-up time was 46 months; median procedure time, 116 minutes; and median hospitalization time, 3 days. In 8.4% of patients, a conversion was performed, and in 20.8%, a complication was registered. The majority of myasthenic patients with a thymoma went into remission, mostly within 12 to 24 months after thymectomy (81%). No statistical difference was found in the number of complications, conversions, incomplete resections, or deaths between patients with myasthenia gravis and nonmyasthenic patients. Thirty-six patients (27.7%) underwent postoperative radiotherapy. The recurrence rate was 9.1%, and the 5-year thymoma-related survival rate was 96.6%. Conclusions: Robotic thymectomy was found to be safe and feasible for early stage thymomas, most advanced-stage thymomas, and thymomatous myasthenia gravis. A national guideline could contribute to the improvement of the oncologic follow-up of thymic epithelial tumors in the Netherlands.
| Original language | English |
|---|---|
| Pages (from-to) | 1886-1894 |
| Number of pages | 9 |
| Journal | Annals of Thoracic Surgery |
| Volume | 114 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Nov 2022 |
Bibliographical note
Funding Information:The authors are grateful to all participating departments in the 60 hospitals in the Netherlands who contributed to this study. Special thanks to all pulmonologists, thoracic surgeons, and neurologists who decided to refer their patients for robotic-assisted thoracic surgery to MUMC+. The authors also wish to thank all included patients for their participation and consent. Janneke G. J. Hoeijmakers reports a grant from the Prinses Beatrix Spierfonds (W.OK17-09), outside the submitted work.
Publisher Copyright:
© 2022 The Society of Thoracic Surgeons