{"doi":"10.1016/j.xjon.2025.11.016","title":"Association of hospital volume with perioperative and long-term outcomes of minimally invasive thymectomy","abstract":"Background Thymectomy is an uncommon procedure, and operative experience may influence outcomes. We examined the association between center-level operative volume using the National Readmissions Database (NRD) and the National Cancer Database (NCDB). These databases provide complementary insights into short- and long-term outcomes. We hypothesized that perioperative morbidity would be similar in high-volume (HV) centers and low-volume (LV) centers, but long-term survival and R0 resection—especially for minimally invasive (MI) thymectomy—would be superior in HV centers. Methods Patients from the NRD (2017-2020) and NCDB (2010-2015 and 2018-2021) diagnosed with thymoma or thymic carcinoma who underwent thymectomy were included. (NCDB 2016-2017 was excluded for missing stage data.) The top quartile defined HV centers from LV centers. The Pearson χ 2 test was used to calculate odds ratios (OR) and 95% confidence intervals (CIs). Logistic regression assessed factors associated with in-hospital mortality, postoperative complications, and R0 resection. Kaplan-Meier analysis evaluated long-term survival. Results In NRD analysis (n = 3127 patients), MI thymectomy was more frequent in HV centers (57.4% vs 40.9%: P < .001). No differences were found in adjusted 30-day mortality (OR, 2.00; 95% CI, 0.69-5.77; P = .20) or postoperative complications (OR, 0.95; 95% CI, 0.76-1.19; P = .65). In NCDB analysis (n = 3798 patients) HV centers were associated with improved 10-year survival (hazard ratio [HR], 0.77; 95% CI, 0.61-0.97; P = .02) and decreased R1/R2 resection (HR, 0.77; 95% CI, 0.64-0.92; P = .004). MI thymectomies at HV centers were associated with a higher rate of R0 resection for stage I and stage II disease (HR, 0.47 [95% CI, 0.31-0.73; P = .001] and HR, 0.77 [95% CI, 0.64-0.97; P = .004], respectively). Conclusions Perioperative outcomes were similar irrespective of center volume, but HV centers demonstrated improved rates of R0 resection and long-term survival even with an MI approach to thymectomy.","journal":"JTCVS Open","year":2025,"id":583142,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.949,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":108228,"name":"Li Ding","orcid":"0000-0003-1517-2975","position":1,"is_corresponding":false},{"id":1495765,"name":"Hannah Sidhu","orcid":null,"position":2,"is_corresponding":false},{"id":1310385,"name":"Graeme Rosenberg","orcid":"0000-0003-3205-1059","position":3,"is_corresponding":false},{"id":970343,"name":"Takashi Harano","orcid":"0000-0003-2047-5436","position":4,"is_corresponding":false},{"id":490146,"name":"Sean C. Wightman","orcid":"0000-0002-6752-4437","position":5,"is_corresponding":false},{"id":490147,"name":"Scott M. Atay","orcid":"0000-0003-1925-6746","position":6,"is_corresponding":false},{"id":490145,"name":"Anthony W. Kim","orcid":"0000-0002-2790-4945","position":7,"is_corresponding":false},{"id":1310386,"name":"Brooks V. Udelsman","orcid":"0000-0002-8158-4540","position":8,"is_corresponding":false},{"id":1495764,"name":"Erin Yu","orcid":null,"position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T02:59:03.725721Z","pmid":"41960060","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}