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What is the prevalence of a "nontherapeutic" thymectomy?

AbstractBACKGROUND:
Thymectomy is often performed on the basis of computed tomography scan findings that are suspicious for thymoma. However, the final diagnosis may be a condition such as thymic hyperplasia or lymphoma for which thymectomy is not therapeutic. The present analysis was undertaken to determine the prevalence of a "nontherapeutic" thymectomy.
METHODS:
The Nationwide Inpatient Sample from 2000 through 2009 was queried to identify patients who underwent a thymectomy. Only adult patients who underwent a total thymectomy without other associated procedures were analyzed. Patients with a diagnosis of myasthenia were excluded. A nontherapeutic thymectomy was defined as a patient who underwent thymectomy with an International Classification of Diseases, Ninth Revision diagnosis code of lymphoma, thymic hyperplasia, thymic cyst, or other benign diseases of the thymus.
RESULTS:
A total of 1,306 patients were identified. Overall, 72.2% (n = 943) of thymectomies were therapeutic and 27.8% (n = 363) were nontherapeutic. The most common diagnosis in the nontherapeutic group was thymic hyperplasia (n = 174). Mortality (0.32% versus 0%; p = 0.083) and overall complication rates (25% versus 17%; p < 0.001) were higher in the therapeutic group. Patients in the nontherapeutic group were younger (median age, 41 versus 56 years; p < 0.001) and more likely to undergo a video-assisted thoracoscopic surgery thymectomy (28% versus 19%; p = 0.085).
CONCLUSIONS:
In this study, 27.8% of thymectomies were nontherapeutic, and most patients underwent an open approach. The most common benign diagnosis was thymic hyperplasia, a condition for which magnetic resonance imaging has a high predictive value. Consequently, further studies are warranted to determine the optimal evaluation of patients undergoing thymectomy for presumed thymoma.
AuthorsMichael S Kent, Thomas Wang, Sidhu P Gangadharan, Richard I Whyte
JournalThe Annals of thoracic surgery (Ann Thorac Surg) Vol. 97 Issue 1 Pg. 276-82; discussion 82 (Jan 2014) ISSN: 1552-6259 [Electronic] Netherlands
PMID24140214 (Publication Type: Comparative Study, Journal Article)
CopyrightCopyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Topics
  • Adult
  • Aged
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphoma (diagnostic imaging, pathology, surgery)
  • Magnetic Resonance Imaging (methods)
  • Male
  • Middle Aged
  • Prevalence
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Thoracic Surgery, Video-Assisted (adverse effects, methods)
  • Thoracotomy (adverse effects, methods)
  • Thymectomy (adverse effects, methods, statistics & numerical data)
  • Thymoma (diagnostic imaging, pathology, surgery)
  • Thymus Hyperplasia (diagnostic imaging, pathology, surgery)
  • Thymus Neoplasms (diagnostic imaging, pathology, surgery)
  • Tomography, X-Ray Computed (methods)
  • Treatment Failure
  • Treatment Outcome

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