A Review of Thymic Tumors

Bushan, Kirti; Sharma, Sanjay; Verma, Harish

doi:10.1007/s13193-013-0214-2

Cited by 18 publications

(17 citation statements)

References 31 publications

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“…[10] The population described in this article was mainly masculine, unlike what was reported in the CLICaP-LATimus and the INC studies, were the proportion was inverted (40% men and 60% woman). [9,10] However, the mean age (52.7 years) was similar to the previous studies, unlike what has been reported in international cohorts, such as the European RARECAREnet projects (2000-20007) [11] or the Japanese publication by Kanemura et al, [12] in which patients were on average a decade older at diagnosis.…”

Section: Discussionsupporting

confidence: 79%

“…As reported in the literature worldwide, the frequency of thymic tumors in both Latin America and Colombia is low; in fact, only 105 patients with thymomas were included in the multicenter study CLICaP-LATimus, [9] which was carried out from 1997 to 2018 in 7 Latin American countries (Mexico, Costa Rica, Colombia, Ecuador, Brazil, Peru and Argentina). In Colombia, a recent publication by Buitrago et al reported 31 patients with thymic tumors who were treated at the National Institute of Cancerology (INC) between 2006 and 2017.…”

Section: Discussionmentioning

confidence: 99%

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Primary Thymus Tumors: Retrospective Case Analysis at a Reference Center in Latin America, 2011 – 2019

Scarpetta-González

Morales

Sua

et al. 2020

Preprint

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BackgroundThymic tumors are unusual neoplasms, representing 0.2% to 1.5% of tumors in humans, but correspond to 20% of mediastinal tumors and 50% of those that occur in the anterior mediastinum. They tend to appear around the fourth and fifth decades of life without gender predilection. Up to 30% of patients are asymptomatic, therefore many are incidentally diagnosed. Radical thymectomy is the treatment of choice with high survival rates when detected in the early stages. Methods This was a retrospective descriptive study, including 18 adult patients’ diagnosis of thymic neoplasm, who were managed with surgical resection from 2011 to 2019. Information about demographics, clinical characteristics, imaging findings, surgical and medical management, plus histological findings was obtained and reported. Results18 patients with thymic tumors were included, of which specific histologic studies reveled thymomas, carcinomas, neuroendocrine tumors, thymolipoma and thymic cyst. Mean age was 52.7 years, with a predominance of male population. The main symptom was dyspnea, followed by cough and chest pain. Paraneoplastic syndromes such as myasthenia gravis, aplastic anemia and Cushing syndrome were reported. 89% of cases were treated by radical thymectomy alone, while only 2 cases required chemotherapy and radiotherapy. There were no surgical complications. Mean hospital stay length was 11. 9 days, with only 1 mortality during hospital admission. 5-year survival rate was 81%. Conclusions The treatment of choice is radical thymectomy, which has been shown to positively impact patient mortality. Early detection is key to improve patient outcomes.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Primary Thymus Tumors: Retrospective Case Analysis at a Reference Center in Latin America, 2011 – 2019

Scarpetta-González

Morales

Sua

et al. 2020

Preprint

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“…Although, thymomas are the most common adult tumors in the anterior mediastinal compartment, it is a rare neoplasm with an overall incidence of 0.13 cases per 100,000 individuals per year (13)(14)(15). A recent study based on a large cohort of patients with thymomas revealed that the 10-year OS rate was 0.73 (95% confidence interval 0.69-0.75) (16).…”

Section: Discussionmentioning

confidence: 99%

Myasthenia gravis in patients with thymoma affects survival rate following extended thymectomy

et al. 2016

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Abstract. Thymomas are the most common adult tumors in the anterior mediastinal compartment, and a significant amount of thymomas are complicated by myasthenia gravis (MG). Extended thymectomy (ET) is the primary treatment method for thymomas and is used to completely resect possible ectopic thymus to avoid recurrence. Studies on the effect of MG in thymoma patients following ET are limited. The aim of the present study was to determine whether the presence of MG affects the prognosis of patients with thymoma. The present study consisted of 104 patients with thymoma that underwent ET; 61 men (58.7%) and 43 women (41.3%) (mean age, 54.6 years). In total, 38 patients had MG (36.5%). MG was most frequently observed in World Health Organization (WHO) classification type B2 thymoma compared with other types of thymoma. During the 5-year follow-up period, 11 patients succumbed to a recurrence of thymoma or respiratory failure due to MG. The overall 5-year survival rate in patients without MG or with MG was 89.1 and 76.0%, respectively. The overall survival (OS) rate in patients with Masaoka stages I + II and III + IV was 90.0 and 68.0%, respectively. The OS rate in patients with WHO type A + AB + B1 and type B2 + B3 was 96.9 and 76.8%, respectively. The patients with MG (P=0.026), Masaoka stages III + IV (P= 0.008) and WHO type B2 + B3 (P=0.032) had a poorer prognosis compared with patients without these characteristics. Furthermore, multivariate analysis by Cox regression revealed that age [P=0.032; relative risk (RR)=1.097; 95% confidence interval (CI)=1. 097-1.192] and MG (P= 0.042; RR= 0.167; 95% CI= 0.037-0.940) significantly affected OS rate. In summary, ET is a reliable method for the treatment of thymoma. Long-term survival is expected for patients at early Masaoka stages, and for patients without MG. The prognosis of patients with thymomas with MG is poorer compared with patients without MG. The present findings provide useful information for the future management of patients with thymomas. IntroductionThymoma is a tumor originating from the epithelial cells of the thymus and is a relatively rare neoplasm with an incidence of 0.13 cases per 100,000 individuals per year (1,2). The prognosis of patients with thymoma largely depends on the Masaoka stage of disease and prognosis is poorer for patients with stage III or IV compared with patients with stage I and II tumors (3). The 10-year survival rates are 90, 70, 55 and 35% for stages I, II, III, and IV thymoma, respectively (4). Surgical resection is the primary treatment method for thymoma and a sternotomy is the optimal surgical procedure for thymoma, since it may not be possible to perform a complete thymectomy via thoracotomy on locally advanced lesions, particularly those that are stage III-IV (5,6). Normally, thymoma is a slow-growing tumor, but 40% of thymomas exhibit a locally invasive growth pattern. In addition, thymomas often result in the development of pleural dissemination and distant metastasis (7,8). Therefore, complete resection should be th...

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“…[ 18 ] According to the International Thymic Malignancy Interest Group, complete resection can only be achieved by removing the whole thymus and surrounding tissue. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of INTRABEAM intraoperative radiotherapy for invasive thymoma

Tianxiang

Dai

et al. 2020

Medicine

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Intraoperative radiotherapy (IORT) has been used to treat different residual solid tumors after tumor removal and has shown many advantages over other treatment methods. However, the use of IORT for invasive thymoma has not been reported. Therefore, in this study, we tried to determine the safety and efficacy of INTRABEAM IORT for the treatment of invasive thymoma. Among the patients admitted to our hospital from September to December 2016 who were diagnosed with invasive thymoma, 14 were selected as study subjects. With medical histories taken beforehand, 8 of these patients were diagnosed with Masaoka stage IIA and 6 with Masaoka stage IIB; furthermore, 5 of the patients were diagnosed with myasthenia gravis (MG). INTRABEAM radiation (8–10 Gy, low energy) was delivered to the postoperative tumor bed of each patient during surgery. The intra- and postoperative complications were observed and evaluated, and the improvement in symptoms was assessed. An additional 23 patients with stage II thymoma undergoing radical surgery from April to August 2016 were chosen as the control group. One month after the operation, only 1 patient in the IORT group had cough, increased levels of leucocytes and neutrophils, and pulmonary inflammation on chest computed tomography. Reactive inflammation and pleural effusion in the 2 groups were similar ( P > .05). There was no significant difference between the 2 groups in the improvement of myasthenia gravis ( P > .05). Postoperative chest computed tomography and routine blood examination at 3 and 12 months showed that all the patients recovered, with normal hemogram levels and no pulmonary fibrosis around the radiation field. In addition, ultrasonic cardiography and electrocardiography demonstrated no significant difference before or after surgery within the IORT group. At the end of the follow-up, all the patients were alive, no relapse or remote metastasis was observed in the IORT group, and 2 inpatients in the control group had experienced relapse at 24 and 26 months. There was a significant difference in disease-free survival between the 2 groups ( P = .00). It is safe to administer low-energy INTRABEAM IORT at a dose of approximately 10 Gy in patients with stage II invasive thymoma. INTRABEAM IORT does not significantly increase operation- or radiation-related complications and has no significant effect on vital organs such as the lungs and heart. Its long-term efficacy is worth expecting.

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A Review of Thymic Tumors

Cited by 18 publications

References 31 publications

Primary Thymus Tumors: Retrospective Case Analysis at a Reference Center in Latin America, 2011 – 2019

Primary Thymus Tumors: Retrospective Case Analysis at a Reference Center in Latin America, 2011 – 2019

Myasthenia gravis in patients with thymoma affects survival rate following extended thymectomy

Safety and efficacy of INTRABEAM intraoperative radiotherapy for invasive thymoma

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