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How can the rate of nontherapeutic thymectomy be reduced?

OBJECTIVES: The aim of this study was to determine the prevalence of nontherapeutic thymectomy and define a clinical standard to reduce it. METHODS: From 2016 to 2020, consecutive patients who underwent thymectomy were retrospectively reviewed. Univariable and multivariable analyses were used to ide...

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Autores principales: Wang, Shuai, Ao, Yongqiang, Jiang, Jiahao, Lin, Miao, Chen, Gang, Liu, Junzhen, Zhao, Shihai, Gao, Jian, Zhang, Yi, Ding, Jianyong, Tan, Lijie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9419679/
https://www.ncbi.nlm.nih.gov/pubmed/35579357
http://dx.doi.org/10.1093/icvts/ivac132
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author Wang, Shuai
Ao, Yongqiang
Jiang, Jiahao
Lin, Miao
Chen, Gang
Liu, Junzhen
Zhao, Shihai
Gao, Jian
Zhang, Yi
Ding, Jianyong
Tan, Lijie
author_facet Wang, Shuai
Ao, Yongqiang
Jiang, Jiahao
Lin, Miao
Chen, Gang
Liu, Junzhen
Zhao, Shihai
Gao, Jian
Zhang, Yi
Ding, Jianyong
Tan, Lijie
author_sort Wang, Shuai
collection PubMed
description OBJECTIVES: The aim of this study was to determine the prevalence of nontherapeutic thymectomy and define a clinical standard to reduce it. METHODS: From 2016 to 2020, consecutive patients who underwent thymectomy were retrospectively reviewed. Univariable and multivariable analyses were used to identify the correlation factors of nontherapeutic thymectomy. A receiver operating characteristic curve was analysed to assess the cut-off threshold of factors correlated with nontherapeutic thymectomy. RESULTS: A total of 1039 patients were included in this study. Overall, 78.4% (n = 814) of thymectomies were therapeutic and 21.6% (n = 225) were nontherapeutic. Thymoma (57.9%, n = 602) was the most common diagnosis in therapeutic thymectomy. Among those of nontherapeutic thymectomy, thymic cysts (11.9%, n = 124) were the most common lesion. Compared with therapeutic thymectomy, patients with nontherapeutic thymectomy were more likely to be younger (median age 50.1 vs 55.6 years, P < 0.001) with a smaller precontrast and postcontrast computed tomography (CT) value (P < 0.001, P < 0.001), as well as ΔCT value [10.7 vs 23.5 Hounsfield units (HU), P < 0.001]. Multivariable analysis indicated that only age and ΔCT value were significantly different between therapeutic and nontherapeutic thymectomy groups. Receiver operating characteristic curve analysis showed that cut-off values of age and ΔCT value were 44 years and 6 HU, respectively. Patients with age ≤44 years and a ΔCT value ≤6 HU had a 95% probability of nontherapeutic thymectomy. CONCLUSIONS: Surgeons should be cautious to perform thymectomy for patients with age ≤44 years and ΔCT value ≤6 HU. This simple clinical standard is helpful to reduce the rate of nontherapeutic thymectomy.
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spelling pubmed-94196792022-08-29 How can the rate of nontherapeutic thymectomy be reduced? Wang, Shuai Ao, Yongqiang Jiang, Jiahao Lin, Miao Chen, Gang Liu, Junzhen Zhao, Shihai Gao, Jian Zhang, Yi Ding, Jianyong Tan, Lijie Interact Cardiovasc Thorac Surg Thoracic OBJECTIVES: The aim of this study was to determine the prevalence of nontherapeutic thymectomy and define a clinical standard to reduce it. METHODS: From 2016 to 2020, consecutive patients who underwent thymectomy were retrospectively reviewed. Univariable and multivariable analyses were used to identify the correlation factors of nontherapeutic thymectomy. A receiver operating characteristic curve was analysed to assess the cut-off threshold of factors correlated with nontherapeutic thymectomy. RESULTS: A total of 1039 patients were included in this study. Overall, 78.4% (n = 814) of thymectomies were therapeutic and 21.6% (n = 225) were nontherapeutic. Thymoma (57.9%, n = 602) was the most common diagnosis in therapeutic thymectomy. Among those of nontherapeutic thymectomy, thymic cysts (11.9%, n = 124) were the most common lesion. Compared with therapeutic thymectomy, patients with nontherapeutic thymectomy were more likely to be younger (median age 50.1 vs 55.6 years, P < 0.001) with a smaller precontrast and postcontrast computed tomography (CT) value (P < 0.001, P < 0.001), as well as ΔCT value [10.7 vs 23.5 Hounsfield units (HU), P < 0.001]. Multivariable analysis indicated that only age and ΔCT value were significantly different between therapeutic and nontherapeutic thymectomy groups. Receiver operating characteristic curve analysis showed that cut-off values of age and ΔCT value were 44 years and 6 HU, respectively. Patients with age ≤44 years and a ΔCT value ≤6 HU had a 95% probability of nontherapeutic thymectomy. CONCLUSIONS: Surgeons should be cautious to perform thymectomy for patients with age ≤44 years and ΔCT value ≤6 HU. This simple clinical standard is helpful to reduce the rate of nontherapeutic thymectomy. Oxford University Press 2022-05-17 /pmc/articles/PMC9419679/ /pubmed/35579357 http://dx.doi.org/10.1093/icvts/ivac132 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Thoracic
Wang, Shuai
Ao, Yongqiang
Jiang, Jiahao
Lin, Miao
Chen, Gang
Liu, Junzhen
Zhao, Shihai
Gao, Jian
Zhang, Yi
Ding, Jianyong
Tan, Lijie
How can the rate of nontherapeutic thymectomy be reduced?
title How can the rate of nontherapeutic thymectomy be reduced?
title_full How can the rate of nontherapeutic thymectomy be reduced?
title_fullStr How can the rate of nontherapeutic thymectomy be reduced?
title_full_unstemmed How can the rate of nontherapeutic thymectomy be reduced?
title_short How can the rate of nontherapeutic thymectomy be reduced?
title_sort how can the rate of nontherapeutic thymectomy be reduced?
topic Thoracic
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9419679/
https://www.ncbi.nlm.nih.gov/pubmed/35579357
http://dx.doi.org/10.1093/icvts/ivac132
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