Thymic carcinoma: A cohort study of patients from the European society of thoracic surgeons database

European Society of Thoracic Surgeons Thymic Working Group

Research output: Contribution to journalArticle

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Abstract

Introduction: Thymic carcinoma is a rare and aggressive thymic neoplasm. The European Society of Thoracic Surgeons developed a retrospective database collecting patients undergoing resection for thymic tumors from 1990 to 2010. Methods: Of 2265 patients with thymic tumors, there were 229 thymic carcinomas. Clinicopathological characteristics were analyzed including age, associated paraneoplastic diseases, stage (Masaoka-Koga), World Health Organization histologic subtypes, type of resection (total/ subtotal/biopsy/no resection), tumor size, pre/postoperative treatments, and recurrence. Outcome measures included overall survival (OS), freedom from recurrence, and cumulative incidence of recurrence. Results: A complete resection was achieved in 140 patients (69%). Recurrence occurred in 54 patients (28%). Five- and 10-year OS rates were 0.61 and 0.37. Five- and 10-year freedom from recurrence rates were 0.60 and 0.43. Cumulative incidence of recurrence was 0.21 (3 yr), 0.27 (5 yr), and 0.32 (10 yr). Survival was better after surgical resection versus biopsy/no resection (p < 0.001), after complete resection versus subtotal resection (p < 0.001), and when using Masaoka-Koga system (stages I-II versus III versus IV) (p < 0.001). The use of multidisciplinary treatments resulted in a survival advantage which was significant in the surgery + radiotherapy group (p = 0.02). Incomplete resection (p < 0.0001) and advanced stage (Masaoka-Koga III-IV) (p = 0.02) had a negative impact on OS at multivariable analysis. Administration of adjuvant radiotherapy was beneficial in increasing OS (p = 0.02). Conclusions: The results of our study indicate that patients with thymic carcinoma should undertake surgical resection whenever possible; a complete resection and early Masaoka-Koga stage are independent predictors of improved survival; our results also suggest that postoperative radiotherapy is beneficial in improving survival.

Original languageEnglish (US)
Pages (from-to)541-548
Number of pages8
JournalJournal of Thoracic Oncology
Volume9
Issue number4
DOIs
StatePublished - 2014

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Thymoma
Cohort Studies
Thorax
Databases
Thymus Neoplasms
Survival
Recurrence
Radiotherapy
Biopsy
Adjuvant Radiotherapy
Incidence
Surgeons
Survival Rate
Outcome Assessment (Health Care)
Therapeutics
Neoplasms

Keywords

  • Prognostic factors
  • Staging
  • Surgery
  • Thymic carcinoma
  • Thymic tumors

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Thymic carcinoma : A cohort study of patients from the European society of thoracic surgeons database. / European Society of Thoracic Surgeons Thymic Working Group.

In: Journal of Thoracic Oncology, Vol. 9, No. 4, 2014, p. 541-548.

Research output: Contribution to journalArticle

European Society of Thoracic Surgeons Thymic Working Group. / Thymic carcinoma : A cohort study of patients from the European society of thoracic surgeons database. In: Journal of Thoracic Oncology. 2014 ; Vol. 9, No. 4. pp. 541-548.
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abstract = "Introduction: Thymic carcinoma is a rare and aggressive thymic neoplasm. The European Society of Thoracic Surgeons developed a retrospective database collecting patients undergoing resection for thymic tumors from 1990 to 2010. Methods: Of 2265 patients with thymic tumors, there were 229 thymic carcinomas. Clinicopathological characteristics were analyzed including age, associated paraneoplastic diseases, stage (Masaoka-Koga), World Health Organization histologic subtypes, type of resection (total/ subtotal/biopsy/no resection), tumor size, pre/postoperative treatments, and recurrence. Outcome measures included overall survival (OS), freedom from recurrence, and cumulative incidence of recurrence. Results: A complete resection was achieved in 140 patients (69{\%}). Recurrence occurred in 54 patients (28{\%}). Five- and 10-year OS rates were 0.61 and 0.37. Five- and 10-year freedom from recurrence rates were 0.60 and 0.43. Cumulative incidence of recurrence was 0.21 (3 yr), 0.27 (5 yr), and 0.32 (10 yr). Survival was better after surgical resection versus biopsy/no resection (p < 0.001), after complete resection versus subtotal resection (p < 0.001), and when using Masaoka-Koga system (stages I-II versus III versus IV) (p < 0.001). The use of multidisciplinary treatments resulted in a survival advantage which was significant in the surgery + radiotherapy group (p = 0.02). Incomplete resection (p < 0.0001) and advanced stage (Masaoka-Koga III-IV) (p = 0.02) had a negative impact on OS at multivariable analysis. Administration of adjuvant radiotherapy was beneficial in increasing OS (p = 0.02). Conclusions: The results of our study indicate that patients with thymic carcinoma should undertake surgical resection whenever possible; a complete resection and early Masaoka-Koga stage are independent predictors of improved survival; our results also suggest that postoperative radiotherapy is beneficial in improving survival.",
keywords = "Prognostic factors, Staging, Surgery, Thymic carcinoma, Thymic tumors",
author = "{European Society of Thoracic Surgeons Thymic Working Group} and Enrico Ruffini and Frank Detterbeck and {van Raemdonck}, Dirk and Gaetano Rocco and Pascal Thomas and Walter Weder and Alessandro Brunelli and Francesco Guerrera and Shaf Keshavjee and Nasser Altorki and Jan Sch{\"u}tzner and Alex Arame and Lorenzo Spaggiari and Eric Lim and Alper Toker and Federico Venuta and Khaled Alkattan and Majed Refai and Caterina Casadio and Paolo Carbognani and Robert Cerfolio and Giovanni Donati and Foroulis, {Christophoros N.} and Cengiz Gebitekin and {de Antonio}, {David Gomez} and Kernstine, {Kemp H.} and Bernhard Moser and Cosimo Lequaglie and Moishe Liberman and Nicholson, {Andrew G.} and Loic Lang-Lazdunski and Maurizio Mancuso and Mario Nosotti and Novoa, {Nuria M.} and Geoffrey Brioude and Filosso, {Pier Luigi} and Paolo Solidoro and Salvatore Saita and Marco Scarci and Alberto Terzi and {van Veer}, Hans and Marco Anile and Erino Rendina and Luca Voltolini and Wojciech Zurek",
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TY - JOUR

T1 - Thymic carcinoma

T2 - A cohort study of patients from the European society of thoracic surgeons database

AU - European Society of Thoracic Surgeons Thymic Working Group

AU - Ruffini, Enrico

AU - Detterbeck, Frank

AU - van Raemdonck, Dirk

AU - Rocco, Gaetano

AU - Thomas, Pascal

AU - Weder, Walter

AU - Brunelli, Alessandro

AU - Guerrera, Francesco

AU - Keshavjee, Shaf

AU - Altorki, Nasser

AU - Schützner, Jan

AU - Arame, Alex

AU - Spaggiari, Lorenzo

AU - Lim, Eric

AU - Toker, Alper

AU - Venuta, Federico

AU - Alkattan, Khaled

AU - Refai, Majed

AU - Casadio, Caterina

AU - Carbognani, Paolo

AU - Cerfolio, Robert

AU - Donati, Giovanni

AU - Foroulis, Christophoros N.

AU - Gebitekin, Cengiz

AU - de Antonio, David Gomez

AU - Kernstine, Kemp H.

AU - Moser, Bernhard

AU - Lequaglie, Cosimo

AU - Liberman, Moishe

AU - Nicholson, Andrew G.

AU - Lang-Lazdunski, Loic

AU - Mancuso, Maurizio

AU - Nosotti, Mario

AU - Novoa, Nuria M.

AU - Brioude, Geoffrey

AU - Filosso, Pier Luigi

AU - Solidoro, Paolo

AU - Saita, Salvatore

AU - Scarci, Marco

AU - Terzi, Alberto

AU - van Veer, Hans

AU - Anile, Marco

AU - Rendina, Erino

AU - Voltolini, Luca

AU - Zurek, Wojciech

PY - 2014

Y1 - 2014

N2 - Introduction: Thymic carcinoma is a rare and aggressive thymic neoplasm. The European Society of Thoracic Surgeons developed a retrospective database collecting patients undergoing resection for thymic tumors from 1990 to 2010. Methods: Of 2265 patients with thymic tumors, there were 229 thymic carcinomas. Clinicopathological characteristics were analyzed including age, associated paraneoplastic diseases, stage (Masaoka-Koga), World Health Organization histologic subtypes, type of resection (total/ subtotal/biopsy/no resection), tumor size, pre/postoperative treatments, and recurrence. Outcome measures included overall survival (OS), freedom from recurrence, and cumulative incidence of recurrence. Results: A complete resection was achieved in 140 patients (69%). Recurrence occurred in 54 patients (28%). Five- and 10-year OS rates were 0.61 and 0.37. Five- and 10-year freedom from recurrence rates were 0.60 and 0.43. Cumulative incidence of recurrence was 0.21 (3 yr), 0.27 (5 yr), and 0.32 (10 yr). Survival was better after surgical resection versus biopsy/no resection (p < 0.001), after complete resection versus subtotal resection (p < 0.001), and when using Masaoka-Koga system (stages I-II versus III versus IV) (p < 0.001). The use of multidisciplinary treatments resulted in a survival advantage which was significant in the surgery + radiotherapy group (p = 0.02). Incomplete resection (p < 0.0001) and advanced stage (Masaoka-Koga III-IV) (p = 0.02) had a negative impact on OS at multivariable analysis. Administration of adjuvant radiotherapy was beneficial in increasing OS (p = 0.02). Conclusions: The results of our study indicate that patients with thymic carcinoma should undertake surgical resection whenever possible; a complete resection and early Masaoka-Koga stage are independent predictors of improved survival; our results also suggest that postoperative radiotherapy is beneficial in improving survival.

AB - Introduction: Thymic carcinoma is a rare and aggressive thymic neoplasm. The European Society of Thoracic Surgeons developed a retrospective database collecting patients undergoing resection for thymic tumors from 1990 to 2010. Methods: Of 2265 patients with thymic tumors, there were 229 thymic carcinomas. Clinicopathological characteristics were analyzed including age, associated paraneoplastic diseases, stage (Masaoka-Koga), World Health Organization histologic subtypes, type of resection (total/ subtotal/biopsy/no resection), tumor size, pre/postoperative treatments, and recurrence. Outcome measures included overall survival (OS), freedom from recurrence, and cumulative incidence of recurrence. Results: A complete resection was achieved in 140 patients (69%). Recurrence occurred in 54 patients (28%). Five- and 10-year OS rates were 0.61 and 0.37. Five- and 10-year freedom from recurrence rates were 0.60 and 0.43. Cumulative incidence of recurrence was 0.21 (3 yr), 0.27 (5 yr), and 0.32 (10 yr). Survival was better after surgical resection versus biopsy/no resection (p < 0.001), after complete resection versus subtotal resection (p < 0.001), and when using Masaoka-Koga system (stages I-II versus III versus IV) (p < 0.001). The use of multidisciplinary treatments resulted in a survival advantage which was significant in the surgery + radiotherapy group (p = 0.02). Incomplete resection (p < 0.0001) and advanced stage (Masaoka-Koga III-IV) (p = 0.02) had a negative impact on OS at multivariable analysis. Administration of adjuvant radiotherapy was beneficial in increasing OS (p = 0.02). Conclusions: The results of our study indicate that patients with thymic carcinoma should undertake surgical resection whenever possible; a complete resection and early Masaoka-Koga stage are independent predictors of improved survival; our results also suggest that postoperative radiotherapy is beneficial in improving survival.

KW - Prognostic factors

KW - Staging

KW - Surgery

KW - Thymic carcinoma

KW - Thymic tumors

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