AB028. Predominance of minimally invasive surgery in the management of thymic neoplasms at a Latin American cancer center: a single-institution cohort.
- 1Department of Thoracic Surgery, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo (USP), São Paulo, Brazil.
Abstract
Thymic epithelial neoplasms are rare tumors of the anterior (prevascular) mediastinum, and complete surgical resection is the cornerstone of treatment. Over the past decade, minimally invasive techniques (video-assisted and robot-assisted thoracoscopic surgery, VATS/RATS) have progressively replaced sternotomy for selected thymic tumors while preserving oncological principles. However, most published series originate from high-income centers in North America, Europe, and Asia, and contemporary data from Latin American public referral hospitals remain scarce. We report the surgical management and immediate perioperative safety of thymic neoplasms at a high-volume Brazilian cancer center. Retrospective analysis of a prospectively maintained institutional REDCap database at a single tertiary cancer center. Consecutive patients operated on between April 2020 and May 2026 for a clinical and radiological diagnosis of thymic neoplasm were included. Recorded variables comprised demographics, tumor location, preoperative biopsy, surgical approach and conversion, operative time, transfusion, intraoperative complications, postoperative destination, and confirmed pathology. Minimally invasive surgery was defined as a VATS or RATS approach without conversion to open surgery. Data were summarized with descriptive statistics; continuous variables are reported as medians (IQR). Sixty-three patients were included; 40 (65%) were women, with a median age of 66 years (IQR 53 to 73). The lesion was located in the anterior mediastinum in 59 patients (94%), and preoperative biopsy was performed in 26. All procedures were elective. A minimally invasive approach was used in 47 patients (81%; VATS 40, RATS 7), and 11 through an open approach (thoracotomy 7, sternotomy 3, clamshell 1), with one conversion to thoracotomy. Median operative time was 180 minutes. Immediate perioperative safety was favorable, with no transfusions, a single intraoperative complication, and postoperative ward destination in 37 patients versus intensive care in 25. When histologically confirmed, thymoma was the predominant diagnosis, followed by benign lesions and secondary tumors. In this Latin American public cancer center, thymic neoplasms were managed predominantly by minimally invasive surgery (81%), with a low conversion rate and favorable perioperative safety, adding evidence for this approach from an underrepresented region.
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BibTeX
@article{vega2026ab028,
title = {{AB028. Predominance of minimally invasive surgery in the management of thymic neoplasms at a Latin American cancer center: a single-institution cohort.}},
author = {Alberto J M Dela Vega and Luiza S Guerra and José D S Moraes Neto and Victor H R Bernardini and Gabriel L Aranha and Ricardo M Terra and Paulo M Pego-Fernandes},
journal = {Mediastinum (Hong Kong, China)},
year = {2026},
month = oct,
doi = {10.21037/med-26-ab028},
url = {https://europepmc.org/article/MED/42999793},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - AB028. Predominance of minimally invasive surgery in the management of thymic neoplasms at a Latin American cancer center: a single-institution cohort.
AU - Alberto J M Dela Vega
AU - Luiza S Guerra
AU - José D S Moraes Neto
AU - Victor H R Bernardini
AU - Gabriel L Aranha
AU - Ricardo M Terra
AU - Paulo M Pego-Fernandes
PY - 2026
DA - 2026/10/30
JO - Mediastinum (Hong Kong, China)
DO - 10.21037/med-26-ab028
UR - https://europepmc.org/article/MED/42999793
AB - Thymic epithelial neoplasms are rare tumors of the anterior (prevascular) mediastinum, and complete surgical resection is the cornerstone of treatment. Over the past decade, minimally invasive techniques (video-assisted and robot-assisted thoracoscopic surgery, VATS/RATS) have progressively replaced sternotomy for selected thymic tumors while preserving oncological principles. However, most published series originate from high-income centers in North America, Europe, and Asia, and contemporary data from Latin American public referral hospitals remain scarce. We report the surgical management and immediate perioperative safety of thymic neoplasms at a high-volume Brazilian cancer center. Retrospective analysis of a prospectively maintained institutional REDCap database at a single tertiary cancer center. Consecutive patients operated on between April 2020 and May 2026 for a clinical and radiological diagnosis of thymic neoplasm were included. Recorded variables comprised demographics, tumor location, preoperative biopsy, surgical approach and conversion, operative time, transfusion, intraoperative complications, postoperative destination, and confirmed pathology. Minimally invasive surgery was defined as a VATS or RATS approach without conversion to open surgery. Data were summarized with descriptive statistics; continuous variables are reported as medians (IQR). Sixty-three patients were included; 40 (65%) were women, with a median age of 66 years (IQR 53 to 73). The lesion was located in the anterior mediastinum in 59 patients (94%), and preoperative biopsy was performed in 26. All procedures were elective. A minimally invasive approach was used in 47 patients (81%; VATS 40, RATS 7), and 11 through an open approach (thoracotomy 7, sternotomy 3, clamshell 1), with one conversion to thoracotomy. Median operative time was 180 minutes. Immediate perioperative safety was favorable, with no transfusions, a single intraoperative complication, and postoperative ward destination in 37 patients versus intensive care in 25. When histologically confirmed, thymoma was the predominant diagnosis, followed by benign lesions and secondary tumors. In this Latin American public cancer center, thymic neoplasms were managed predominantly by minimally invasive surgery (81%), with a low conversion rate and favorable perioperative safety, adding evidence for this approach from an underrepresented region.
SN - 2522-6711
ER -