Objective:

To review the latest evidence-based medical progress regarding the selection of surgical approaches and postoperative adjuvant treatment decisions for locally advanced thymoma, emphasizing the significance of personalized treatment strategies.

Key Findings:

• Minimally invasive surgery can achieve oncological outcomes comparable to open surgery while reducing perioperative complications.
• Risk stratification models based on WHO classification, resection margin status, and tumor burden are critical in guiding postoperative radiotherapy decisions.
• New technologies such as proton therapy may reduce cardiac toxicity in patients undergoing radiotherapy.

Interpretation:

The article constructs a dynamic individualized treatment decision-making framework by integrating multidisciplinary perspectives, including surgical, oncological, and radiological insights, to balance oncological efficacy and patient quality of life.

Limitations:

• The traditional treatment paradigm lacks uniform standards for adjuvant radiotherapy, particularly for completely resected early-stage tumors, and may be influenced by biases in the studies reviewed.
• Current international guidelines conservatively recommend open sternotomy for locally advanced cases, limiting the application of minimally invasive surgery.

Conclusion:

The review emphasizes the need for individualized management strategies in treating locally advanced thymoma, integrating surgical and radiotherapy advancements, and highlights the potential for improved patient outcomes.