{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T05:14:17Z","timestamp":1767849257006,"version":"3.49.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81972168"],"award-info":[{"award-number":["81972168"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research Development Fund of Zhongshan Hospital, Fudan University","award":["2020ZSCX11"],"award-info":[{"award-number":["2020ZSCX11"]}]},{"name":"Research Development Fund of Zhongshan Hospital, Fudan University","award":["2021ZSYQ28"],"award-info":[{"award-number":["2021ZSYQ28"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The aim of this study was to determine the prevalence of nontherapeutic thymectomy and define a clinical standard to reduce it.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>From 2016 to 2020, consecutive patients who underwent thymectomy were retrospectively reviewed. Univariable and multivariable analyses were used to identify the correlation factors of nontherapeutic thymectomy. A receiver operating characteristic curve was analysed to assess the cut-off threshold of factors correlated with nontherapeutic thymectomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 1039 patients were included in this study. Overall, 78.4% (n\u2009=\u2009814) of thymectomies were therapeutic and 21.6% (n\u2009=\u2009225) were nontherapeutic. Thymoma (57.9%, n\u2009=\u2009602) was the most common diagnosis in therapeutic thymectomy. Among those of nontherapeutic thymectomy, thymic cysts (11.9%, n\u2009=\u2009124) were the most common lesion. Compared with therapeutic thymectomy, patients with nontherapeutic thymectomy were more likely to be younger (median age 50.1 vs 55.6\u2009years, P\u2009&amp;lt;\u20090.001) with a smaller precontrast and postcontrast computed tomography (CT) value (P\u2009&amp;lt;\u20090.001, P\u2009&amp;lt;\u20090.001), as well as \u0394CT value [10.7 vs 23.5 Hounsfield units (HU), P\u2009&amp;lt;\u20090.001]. Multivariable analysis indicated that only age and \u0394CT value were significantly different between therapeutic and nontherapeutic thymectomy groups. Receiver operating characteristic curve analysis showed that cut-off values of age and \u0394CT value were 44\u2009years and 6 HU, respectively. Patients with age \u226444\u2009years and a \u0394CT value \u22646 HU had a 95% probability of nontherapeutic thymectomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Surgeons should be cautious to perform thymectomy for patients with age \u226444\u2009years and \u0394CT value \u22646 HU. This simple clinical standard is helpful to reduce the rate of nontherapeutic thymectomy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivac132","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T12:08:58Z","timestamp":1652789338000},"source":"Crossref","is-referenced-by-count":7,"title":["How can the rate of nontherapeutic thymectomy be reduced?"],"prefix":"10.1093","volume":"35","author":[{"given":"Shuai","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongqiang","family":"Ao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahao","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miao","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junzhen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shihai","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Radiology, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianyong","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijie","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"2022082714281414200_ivac132-B1","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.critrevonc.2016.01.012","article-title":"Thymoma and thymic carcinomas","volume":"99","author":"Scorsetti","year":"2016","journal-title":"Crit Rev Oncol Hematol"},{"key":"2022082714281414200_ivac132-B2","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.ejrad.2014.11.042","article-title":"High rate of unnecessary thymectomy and its cause. Can computed tomography distinguish thymoma, lymphoma, thymic hyperplasia, and thymic cysts?","volume":"84","author":"Ackman","year":"2015","journal-title":"Eur J Radiol"},{"key":"2022082714281414200_ivac132-B3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.lungcan.2018.10.018","article-title":"Systemic treatments for thymoma and thymic carcinoma: a systematic review","volume":"126","author":"Berghmans","year":"2018","journal-title":"Lung Cancer"},{"key":"2022082714281414200_ivac132-B4","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.ejrad.2007.10.002","article-title":"Anterior mediastinal tumors: diagnostic accuracy of CT and MRI","volume":"69","author":"Tomiyama","year":"2009","journal-title":"Eur J Radiol"},{"key":"2022082714281414200_ivac132-B5","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.21037\/jtd.2016.07.83","article-title":"Preoperative misdiagnosis analysis and accurate distinguish intrathymic cyst from small thymoma on computed tomography","volume":"8","author":"Li","year":"2016","journal-title":"J Thorac Dis"},{"key":"2022082714281414200_ivac132-B6","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.athoracsur.2013.07.121","article-title":"What is the prevalence of a \"nontherapeutic\" thymectomy?","volume":"97","author":"Kent","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"2022082714281414200_ivac132-B7","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1097\/JTO.0b013e318207cd74","article-title":"Management of thymic tumors: a survey of current practice among members of the European Society of Thoracic Surgeons","volume":"6","author":"Ruffini","year":"2011","journal-title":"J Thorac Oncol"},{"key":"2022082714281414200_ivac132-B8","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/j.athoracsur.2020.10.032","article-title":"Modified subxiphoid thoracoscopic thymectomy for locally invasive thymoma","volume":"112","author":"Jiang","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2022082714281414200_ivac132-B9","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/j.athoracsur.2012.04.097","article-title":"Minimally invasive thymectomy and open thymectomy: outcome analysis of 263 patients","volume":"94","author":"Jurado","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2022082714281414200_ivac132-B10","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/j.jtcvs.2010.08.005","article-title":"Should asymptomatic enlarged thymus glands be resected?","volume":"140","author":"Singla","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022082714281414200_ivac132-B11","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1080\/14737175.2019.1600404","article-title":"An update on thymectomy in myasthenia gravis","volume":"19","author":"Evoli","year":"2019","journal-title":"Expert Rev 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