Pulle Mohan Venkatesh, Asaf Belal Bin, Puri Harsh Vardhan, Bishnoi Sukhram, Kumar Arvind
Centre for Chest Surgery, Sir Ganga Ram Hospital, New Delhi, India.
J Chest Surg. 2021 Apr 5;54(2):127-136. doi: 10.5090/jcs.20.140.
This meta-analysis aimed to evaluate the incidence of tumor recurrence, postoperative myasthenia gravis, postoperative complications, and overall survival after limited versus total thymectomy for Masaoka stage I and II thymoma.
A systematic search of the literature was conducted using the PubMed, Embase, MEDLINE, and Cochrane databases to identify relevant studies that compared limited and total thymectomy in Masaoka stage I-II patients. The quality of the included observational studies was assessed using the Newcastle-Ottawa Scale. The results of the meta- analysis were expressed as log-transformed odds ratios (log ORs), with 95% confidence intervals (CIs).
Seven observational studies with a total of 2,310 patients were included in the meta-analysis. There was an overall non-significant difference in favor of total thymectomy in terms of tumor recurrence (pooled log OR, 0.40; 95% CI, -0.07 to 0.87; p=0.10; I=0%) and postoperative myasthenia gravis (pooled log OR, 0.12; 95% CI, -1.08 to 1.32; p=0.85; I=22.6%). However, an overall non-significant difference was found in favor of limited thymectomy with respect to postoperative complications (pooled log OR, -0.21; 95% CI, -1.08 to 0.66; p=0.64; I=36.1%) and overall survival (pooled log OR, -0.01; 95% CI, -0.68 to 0.66; p=0.98; I=47.8%).
Based on the results of this systematic review and meta-analysis, limited thymectomy as a treatment for stage I and II thymoma shows similar oncologic outcomes to total thymectomy.
本荟萃分析旨在评估对于Masaoka I期和II期胸腺瘤，行局限性胸腺切除术与全胸腺切除术相比，肿瘤复发率、术后重症肌无力、术后并发症及总生存率的情况。
通过检索PubMed、Embase、MEDLINE和Cochrane数据库对文献进行系统检索，以识别比较Masaoka I-II期患者局限性和全胸腺切除术的相关研究。采用纽卡斯尔-渥太华量表评估纳入的观察性研究的质量。荟萃分析结果以对数转换比值比（log ORs）及95%置信区间（CIs）表示。
荟萃分析纳入了7项观察性研究，共2310例患者。在肿瘤复发方面（合并log OR，0.40；95% CI，-0.07至0.87；p = 0.10；I² = 0%）和术后重症肌无力方面（合并log OR，0.12；95% CI，-1.08至1.32；p = 0.85；I² = 22.6%），总体上全胸腺切除术并无显著优势。然而，在术后并发症方面（合并log OR，-0.21；95% CI，-1.08至0.66；p = 0.64；I² = 36.1%）和总生存率方面（合并log OR，-0.01；95% CI，-0.68至0.66；p = 0.98；I² = 47.8%），总体上局限性胸腺切除术并无显著劣势。
基于本系统评价和荟萃分析的结果，局限性胸腺切除术作为I期和II期胸腺瘤的一种治疗方法，其肿瘤学结局与全胸腺切除术相似。
