Surgical Management and Outcomes of 159 Mediastinal Tumor Cases: A Comprehensive Analysis

Abstract

<bold>INTRODUCTION:</bold> Mediastinal tumors (MTs) vary in location, extent, and nature, requiring different surgical approaches, each with variable postoperative outcomes. This study evaluates the surgical management and outcomes of MTs. <bold>Materials and methods:</bold> This retrospective study includes patients who underwent surgery for histologically confirmed MTs at a single center from January 1987 to December 2024. <bold>RESULTS:</bold> A total of 159 patients were included, with a mean age of 44.1 years (range: 2-78). Female patients comprised 57.8% of the cohort, with a sex ratio of 0.73. In 23 patients (14.4%), tumors were discovered incidentally, while 136 patients (85.6%) presented with symptoms. The mean tumor size was 55.7 mm (range: 10-260 mm). CT findings were concordant with histology in 127 cases (79.8%) and discordant in 32 cases (20.2%). Tumors were primarily thymic (50.3%), followed by neurogenic tumors (17.6%), bronchogenic cysts (7.5%), plunging goiters (5.6%), and ectopic parathyroid adenomas (5%). Open surgery was performed in 89.9% of cases, with median sternotomy in 44% and posterolateral thoracotomy in 27%. Minimally invasive surgery was used in 10.1%. The 90-day postoperative mortality rate was 1.8%. Early recovery was uneventful in 127 patients (79.8%). Of the 105 patients followed for over 24 months, 88.5% had no late complications. Recurrences occurred in 6 cases, all of which involved invasive thymomas or thymic carcinomas. <bold>CONCLUSIONS:</bold> Surgery is a key treatment for MTs. This series shows a high prevalence of open surgery with favorable short and long-term outcomes and a low mortality rate.