Long-term survival after superior vena cava resection and reconstruction for locally advanced epithelial thymic tumors invading superior vena cava.

Objectives: Thymic epithelial tumors (TETs) invading superior vena cava have traditionally posed significant surgical challenges. However, advances in surgical techniques have expanded treatment options. This study aimed to evaluate the long-term survival outcomes following superior vena cava resection and reconstruction in patients with locally advanced TETs. Methods: We retrospectively analyzed 50 consecutive patients with TETs invading superior vena cava who underwent surgical resection and vascular reconstruction at our center between March 2015 and September 2023. Survival outcomes were assessed by Kaplan-Meier methods, and prognostic factors were analyzed using Cox regression. Results: All patients achieved complete resection. The mean patient age was 53.0 years, with 68.0% male predominance. Thymomas accounted for 50% of cases. The median follow-up time was 41 months. The 5-year disease-free survival and overall survival rates were 32.2% and 71.4%, respectively. There were no statistical differences between thymomas and thymic carcinomas in disease-free survival (mean, 40.1 ± 5.2 vs 35.5 ± 6.4 months; Conclusions: Aggressive surgical resection with superior vena cava reconstruction is feasible and offers favorable long-term survival in selected patients with locally advanced TETs.