Current and Future Issues in the Surgical Treatment of Thymic Epithelial Tumors: a Review

Surgery is the cornerstone of the treatment of thymic epithelial tumors, and favorable results are observed after complete surgical treatment of early-stage tumors. In locally advanced tumors, induction and adjuvant treatments are associated with surgery to improve complete resection rate and long-term survival. Several issues concerning the surgical treatment of thymic tumors are nevertheless still a matter of discussion and have been therefore to be analyzed. Minimally invasive surgical approaches were increasingly used in the last years, but their role in the treatment of locally advanced tumors is still to be defined. Moreover, although extended thymectomy is considered the standard surgical approach, limited resections such as thymomectomy are also currently used in the treatment of early-stage thymomas. The role of systematic nodal dissection in the surgical treatment of thymomas has also to be defined. Other significant issues concern the role of induction and adjuvant treatments in locally advanced thymic tumors and the role of surgery in the treatment of tumor recurrences. The mainstays and future perspectives in the field were reviewed from MEDLINE and Scopus databases based on appropriate keywords.