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Background <p>Primary giant mediastinal neoplasms are extremely uncommon. Large-sample studies are rare yet urgently needed.</p> Methods <p>We 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.</p> Results <p>Thirty-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&#xa0;min (interquartile range, IQR: 149–252), with a median blood loss of 500&#xa0;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 (<i>p</i> = 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 (<i>p</i> = 0.896). R2 resection correlated with significantly poorer survival compared to R0 (<i>p</i> = 0.001).</p> Conclusions <p>With 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.</p>

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Surgical management of 32 primary giant mediastinal neoplasms: a retrospective single-center analysis

  • 期刊论文

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  • 发表日期：

    2026年4月3日

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  • Qihang Zhu,
  • Zhe He,
  • Jing Zhan,
  • Xiaojing Yao,
  • Shuang Zhao,
  • Kai Chen,
  • Qingrong Ma,
  • Wei Liang,
  • Guibin Qiao,
  • Haiping Xiao

摘要

Background

Primary giant mediastinal neoplasms are extremely uncommon. Large-sample studies are rare yet urgently needed.

Methods

We 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.

Results

Thirty-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).

Conclusions

With 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.