ArticleInternational journal of clinical oncology2026
Nationwide trends in mediastinal tumor and myasthenia gravis surgery in Japan: a decade claims-based analysis (2014-2023).
Article in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMediastinal tumor surgery and extended thymectomy for myasthenia gravis (MG) have undergone significant changes with the advancement of minimally invasive techniques. However, nationwide population-based data capturing these trends in Japan remain limited. This study aimed to characterize national surgical trends for mediastinal tumors and MG using a comprehensive administrative claims database.
methodsWe analyzed data extracted from the National Database of Health Insurance Claims and Specific Health Checkups (NDB), covering over 95% of insured procedures in Japan. We classified surgeries from 2014 to 2023 by disease category (benign tumor/malignant tumor/MG) and approach (open/thoracoscopic/robotic-assisted). Crude and age-standardized surgery rates were calculated per 100,000 person-years. Temporal trends were assessed using linear and Poisson regression models.
resultsIn 2023, a total of 6214 surgeries was performed: 54.4% for benign tumors, 41.6% for malignant tumors, and 4.0% for MG. Thoracoscopic approaches accounted for 76.4% of all procedures (29.4% robotic-assisted), while open surgery comprised 23.6%. Over the decade, age-standardized overall mediastinal tumor surgeries increased significantly (P = 0.0001), driven by marked rises in malignant, thoracoscopic, and robotic-assisted surgeries (each P < 0.0001). In contrast, extended thymectomies and open surgeries declined (P = 0.0019, and < 0.0001, respectively). Age-standardized malignant tumor surgery rates rose in both sexes (relative risk = 1.051 for males, 1.065 for females, and 1.058 overall; P < 0.0001), especially among those aged ≥ 40 years in both sexes (P < 0.0024).
conclusionThis nationwide study reveals growing surgical demand for mediastinal tumors and underscores the widespread adoption of minimally invasive techniques.
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