Presenting Symptomatology of Mediastinal Masses and Its Effect on Surgical Outcomes

• Published in: The American surgeon 2022-02, Vol.88 (2), p.212-218
• Main Authors: Napolitano, Michael A, Werba, Gregor, Desai, Sonia A, Sparks, Andrew D, Mortman, Keith D
• Format: Article
• Language: English
• Subjects: Asymptomatic; Asymptomatic Diseases; Body mass index; Chest Pain - etiology; Chronic obstructive pulmonary disease; Databases, Factual; Deglutition Disorders - etiology; Demographics; Demography; Diplopia; Dysphagia; Dyspnea; Dyspnea - etiology; Female; Humans; Hypertension; Length of Stay; Male; Mediastinal Neoplasms - complications; Mediastinal Neoplasms - pathology; Mediastinal Neoplasms - surgery; Medical records; Middle Aged; Multivariate Analysis; Myasthenia gravis; Ostomy; Pain; Patients; Postoperative period; Respiration; Retrospective Studies; Sleep apnea; Standard deviation; Surgery; Surgical outcomes; Symptom Assessment; Thorax; Tumor Burden; Tumors
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/0003134821989038

Objective Mediastinal masses are commonly encountered by the thoracic surgeon. Few studies have reported on the frequency and characteristics of symptoms at presentation. The primary objective of this study is to determine how often patients present with symptoms from a mediastinal mass. The secondary objective is to determine if the presence of symptoms has an effect on outcomes after surgery. Methods A retrospective review of an institutional database was performed. All patients who underwent surgical resection of a mediastinal mass from 2013 to 2019 were included in the analysis. Medical records were reviewed for the presence or absence of symptoms preoperatively, and these cohorts were compared. Multivariable analysis was performed, adjusting for clinical variables to assess for differences between these cohorts. Results 70 patients underwent surgery for a mediastinal mass. The average age was 49.2 years, and 46 patients (65.7%) presented with symptoms. There were no significant differences in demographics between the symptomatic and asymptomatic groups. The most common symptom was dyspnea in 18 patients (22%), followed by chest pain (15 patients, 19%) and dysphagia (8 patients, 10%). When comparing symptomatic and asymptomatic patients, symptomatic patients had a larger tumor size (5.8 cm vs 3.8 cm, P = .04) and a longer length of stay (2.0 days vs 1.2 days, P = .02). Conclusions The majority of patients with mediastinal masses present with symptoms, with the most common symptom being dyspnea. Symptomatic patients are more likely to have a larger tumor and tend to have a longer length of hospital stay postoperatively compared to asymptomatic patients.