AB007. Is phrenic nerve sparing worthwhile for phrenic-involved thymic epithelial tumors: a retrospective cohort study
Year: 2026
Type: conference-abstract
Abstract: BACKGROUND: To determine whether phrenic nerve (PN) sparing offers a worthwhile trade-off between functional preservation and oncologic safety compared with resection in PN-involved thymic epithelial tumors (TETs), and to establish an objective tool for postoperative respiratory risk stratification. METHODS: In this retrospective cohort of TETs with PN invasion, 122 propensity score–matched cases were analyzed from 2016 to 2024. PN preservation or resection was determined intraoperatively based on the extent of invasion. Diaphragmatic elevation (DE) ratio was calculated as [(preoperative diaphragm–apex distance − postoperative distance)/preoperative distance] × 100% according to X-rays, and cutoff values were defined by respiratory complication risk. Perioperative and oncologic outcomes were compared between PN-preservation and PN-resection groups. RESULTS: Overall perioperative morbidity and recovery outcomes were comparable between the PN-sparing and PN-resection groups. However, tumor progression was significantly more frequent following PN-sparing (39.3% vs. 23.0%), resulting in worse progression-free survival (P=0.03), although overall survival remained comparable. Multivariable analysis identified PN preservation as an independent predictor of progression (P=0.049). Furthermore, our ROC-derived DE classification (mild ≤15%, moderate 15%–25%, severe ≥25%) predicted severe postoperative respiratory complications (P<0.001). CONCLUSIONS: PN resection improves progression-free survival without increasing severe perioperative complications, though overall survival remains comparable.
Source: Mediastinum
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225092004