ArticleJournal of cardiothoracic surgery2026
Surgical management of 32 primary giant mediastinal neoplasms: a retrospective single-center analysis.
Article in Journal of cardiothoracic surgery, 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
backgroundPrimary giant mediastinal neoplasms are extremely uncommon. Large-sample studies are rare yet urgently needed.
methodsWe conducted a retrospective analysis of consecutive cases who underwent excision surgery for giant mediastinal neoplasms between January 2019 and December 2023. Demographic, surgical, and prognosis data were retrospective collected and analyzed.
resultsThirty-two cases were analyzed. The most prevalent location was prevascular compartment (21 cases, 65.6%), followed by visceral compartment (9 cases, 28.1%), and paravertebral compartment (2 cases, 6.3%). Eighteen cases underwent preoperative biopsy, of which 15 consistent with postoperative outcomes. Seven cases underwent preoperative embolization. Median thoracotomy was the most common surgical approach (23 cases, 71.9%). The median operation time was 214 min (interquartile range, IQR: 149–252), with a median blood loss of 500 ml (IQR: 200–800). Thymic tumors were the most prevalent (13 cases, 40.6%), followed by mesenchymal (9 cases, 28.1%), germ-cell (5 cases, 15.6%), pulmonary malignant neoplasms (2 cases, 6.2%), and other rare types (3 cases, 9.4%). The pathological classification demonstrated a significant association with prognosis (p = 0.006), with pulmonary malignancies exhibiting the worst outcomes. No significant overall survival difference was observed in malignant tumor patients with versus without local organ invasion (p = 0.896). R2 resection correlated with significantly poorer survival compared to R0 (p = 0.001).
conclusionsWith varied pathological types and complex surgical procedures, giant mediastinal tumors demand multidisciplinary treatment in experienced centers. Complete surgical resection is key to a good prognosis.
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