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Prognostic factors of stage I thymic epithelial tumors

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Abstract

Objective

According to the tumor-node-metastasis classification for thymic malignancies, the proportion of patients diagnosed with stage I is expected to increase significantly. However, whether those patients have homogenous clinicopathological features and survival has not been fully evaluated.

Methods

We reviewed 153 consecutive patients with stage I thymic epithelial tumors (133 thymomas, 15 thymic carcinomas, and 5 neuroendocrine tumors) who underwent complete resection at our institution between 2001 and 2016 and evaluated the prognostic significance of their clinicopathological factors.

Results

The stage I patients accounted for 78% of all thymic epithelial tumors. The 5-year overall survival and recurrence-free survival rates of the 153 patients were 94% and 80%, respectively. The patients with the histology of thymic carcinoma or neuroendocrine tumor and with a tumor larger than 5.0 cm showed significantly worse recurrence-free survival in multivariate analysis (p = 0.027 and 0.038, respectively). Only the tumor size was revealed as a significant prognostic factor for recurrence-free survival when limited in the 133 cases of thymoma (p = 0.048).

Conclusions

Patients with large tumors showed significantly worse recurrence-free survival than those with small tumors both in stage I thymic epithelial tumors and thymomas.

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References

  1. Brierley J, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours. 8th ed. Hoboken: Wiley; 2017.

    Google Scholar 

  2. Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, et al., editors. AJCC cancer staging manual. New York: Springer; 2016.

    Google Scholar 

  3. Detterbeck FC, Asamura H, Crowley J, Falkson C, Giaccone G, Giroux D, et al. The IASLC/ITMIG thymic malignancies staging project: development of a stage classification for thymic malignancies. J Thorac Oncol. 2013;8:1467–73.

    Article  Google Scholar 

  4. Nicholson AG, Detterbeck FC, Marino M, Kim J, Stratton K, Giroux D, et al. The IASLC/ITMIG Thymic Epithelial Tumors Staging Project: proposals for the T Component for the forthcoming (8th) edition of the TNM classification of malignant tumors. J Thorac Oncol. 2014;9:S73–80.

    Article  Google Scholar 

  5. Kondo K, Van Schil P, Detterbeck FC, Okumura M, Stratton K, Giroux D, et al. The IASLC/ITMIG Thymic Epithelial Tumors Staging Project: proposals for the N and M components for the forthcoming (8th) edition of the TNM classification of malignant tumors. J Thorac Oncol. 2014;9:S81–7.

    Article  Google Scholar 

  6. Detterbeck FC, Stratton K, Giroux D, Asamura H, Crowley J, Falkson C, et al. The IASLC/ITMIG Thymic Epithelial Tumors Staging Project: proposal for an evidence-based stage classification system for the forthcoming (8th) edition of the TNM classification of malignant tumors. J Thorac Oncol. 2014;9:S65–72.

    Article  Google Scholar 

  7. Bhora FY, Chen DJ, Detterbeck FC, Asamura H, Falkson C, Filosso PL, et al. The ITMIG/IASLC Thymic Epithelial Tumors Staging Project: a proposed lymph node map for thymic epithelial tumors in the forthcoming 8th edition of the TNM classification of malignant tumors. J Thorac Oncol. 2014;9:S88–96.

    Article  Google Scholar 

  8. Detterbeck FC, Nicholson AG, Kondo K, Van Schil P, Moran C. The Masaoka–Koga stage classification for thymic malignancies: clarification and definition of terms. J Thorac Oncol. 2011;6:S1710–16.

    Article  Google Scholar 

  9. Koga K, Matsuno Y, Noguchi M, Mukai K, Asamura H, Goya T, et al. A review of 79 thymomas: modification of staging system and reappraisal of conventional division into invasive and non-invasive thymoma. Pathol Int. 1994;44:359–67.

    Article  CAS  Google Scholar 

  10. Masaoka A, Monden Y, Nakahara K, Tanioka T. Follow-up study of thymomas with special reference to their clinical stages. Cancer. 1981;48:2485–92.

    Article  CAS  Google Scholar 

  11. Ströbel P, Kurrer M, Marx A, Marchevsky A, Badve S, Marom E. Tumours of the thymus. In: Travis W, Brambilla E, Burke A, Marx A, Nicholson A, editors. WHO Classification of tumours of the lung, pleura, thymus and heart. 4th ed. Lyon: IARC Press; 2015. p. 183–243.

    Google Scholar 

  12. Blumberg D, Port JL, Weksler B, Delgado R, Rosai J, Bains MS, et al. Thymoma: a multivariate analysis of factors predicting survival. Ann Thorac Surg. 1995;60:908–13. (Discussion 14)

    Article  CAS  Google Scholar 

  13. Nakagawa K, Asamura H, Matsuno Y, Suzuki K, Kondo H, Maeshima A, et al. Thymoma: a clinicopathologic study based on the new World Health Organization classification. J Thorac Cardiovasc Surg. 2003;126:1134–40.

    Article  Google Scholar 

  14. Wright CD, Wain JC, Wong DR, Donahue DM, Gaissert HA, Grillo HC, et al. Predictors of recurrence in thymic tumors: importance of invasion, World Health Organization histology, and size. J Thorac Cardiovasc Surg. 2005;130:1413–21.

    Article  Google Scholar 

  15. Okumura M, Yoshino I, Yano M, Watanabe SI, Tsuboi M, Yoshida K, et al. Tumour size determines both recurrence-free survival and disease-specific survival after surgical treatment for thymoma. Eur J Cardiothorac Surg. 2019;56:174–81.

    Article  Google Scholar 

  16. Fukui T, Fukumoto K, Okasaka T, Kawaguchi K, Nakamura S, Hakiri S, et al. Clinical evaluation of a new tumor-node-metastasis staging system for thymic malignancies proposed by the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee and the International Thymic Malignancy Interest Group. Eur J Cardiothorac Surg. 2016;49:574–9.

    Article  Google Scholar 

  17. Verghese ET, den Bakker MA, Campbell A, Hussein A, Nicholson AG, Rice A, et al. Interobserver variation in the classification of thymic tumours—a multicentre study using the WHO classification system. Histopathology. 2008;53:218–23.

    Article  CAS  Google Scholar 

  18. Sakakura N, Tateyama H, Nakamura S, Taniguchi T, Usami N, Ishikawa Y, et al. Diagnostic reproducibility of thymic epithelial tumors using the World Health Organization classification: note for thoracic clinicians. Gen Thorac Cardiovasc Surg. 2013;61:89–95.

    Article  Google Scholar 

  19. Suster S, Moran CA. Thymoma classification: current status and future trends. Am J Clin Pathol. 2006;125:542–54.

    Article  Google Scholar 

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Acknowledgements

The authors thank Dr. Hisashi Tateyama for the diagnosis of all tumors in this study.

Funding

This work was not supported by any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Takayuki Fukui, Yuka Kadomatsu, Hideki Tsubouchi, Keita Nakanishi, Harushi Ueno, Tomoshi Sugiyama, Masaki Goto, Naoki Ozeki, Shota Nakamura & Toyofumi Fengshi Chen-Yoshikawa

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  1. Takayuki Fukui
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  2. Yuka Kadomatsu
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  3. Hideki Tsubouchi
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  4. Keita Nakanishi
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  5. Harushi Ueno
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  6. Tomoshi Sugiyama
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  7. Masaki Goto
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  8. Naoki Ozeki
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  9. Shota Nakamura
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  10. Toyofumi Fengshi Chen-Yoshikawa
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Correspondence to Takayuki Fukui.

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Fukui, T., Kadomatsu, Y., Tsubouchi, H. et al. Prognostic factors of stage I thymic epithelial tumors. Gen Thorac Cardiovasc Surg 69, 59–66 (2021). https://doi.org/10.1007/s11748-020-01427-x

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  • DOI: https://doi.org/10.1007/s11748-020-01427-x

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