Epidemiology of thymic epithelial tumors: 22‐years experience from a single‐institution

Abstract

Background To assess the correlation of WHO histological classification and Masaoka–Koga staging system of thymic epithelial tumors (TETs) with prognosis. Methods We retrospectively analyzed 83 patients with TETs in the Instituto Nacional de Enfermedades Neoplasicas between 1996 to 2018. We analyzed the clinical stages, histological types and treatment modalities and attempted to determine the impact on overall survival. The data was retrieved from clinical files and reviewed by a pathologist who reclassificated according to the 2004 WHO classification system. The staging was performed with the Masaoka–Koga staging system. Survival curves were constructed with Kaplan‐Meir method. Results There was a total of 83 patients with a median age of 55 years old included in the study. The histological type corresponded to thymoma (T) in 63.8% (n = 53) and to thymic carcinoma (TC) in 36.1%. T were type A, AB, B1, B2 and B3 in 14.4%, 18%, 12%, 3.6%, 7.4% of cases, respectively. The proportion of advanced disease (Masaoka stage III–IV) was high (65%). With a median follow‐up of 88.4 months, median overall survival (OS) was 81.6 months for T and 12.3 months for TC (P = 0.01). Univariate analysis showed that sex, histological type, clinical stage and surgery (P = 0.01) were significant independent prognostic factors. On multivariate analysis, histology type and Masaoka–Koga staging had an effect on survival. Conclusions The results indicates a clear association between the WHO histological classification and Masaoka–Koga staging system with survival. We found a higher proportion of TETs with advanced disease at diagnosis. Further research are required and collaboration is important to foster knowledge focused on classification and treatment. Key points Significant findings of the study The WHO histological classification, the Masaoka–Koga system and surgery treatment were associated with overall survival. What this study adds To determine prognosis factors in TETs.

Prognostic factors and genetic markers in thymic epithelial tumors: A narrative review

“…As already mentioned, the different proportions of each histological type in the available series could explain the discrepancies in the survival rates, nevertheless there is a clear correlation between advanced stages and worse prognosis. In the series by Rioja et al, advanced Masaoka‐Koga stages (III and IV) were a poor prognostic factor (OS 16 months) 29 …”

“…Similarly, in the series of Rioja et al, 83 TET were treated over a 22‐year period. Advanced histological WHO types were associated with worse prognosis (OS 16.7 months for B2, B3 types and 12.3 months for thymic carcinomas) 29 …”

“…Advanced histological WHO types were associated with worse prognosis (OS 16.7 months for B2, B3 types and 12.3 months for thymic carcinomas). 29 …”

Coexistence of thymoma and necrotizing pneumonia: a case report with a fatal outcome

“…They are divided into thymomas (T) and thymic carcinoma (TC), the most common being thymoma, which corresponds to between 85%-95% of cases and TC to 5%-15%. Mean age at diagnosis is 53 years for T and 54 years for CT. 1 Due to the wide use of tomography, many patients with thymomas are discovered incidentally through this study. When they present symptoms, they are usually related to compression or invasion of adjacent tissues, manifesting as dysphagia, diaphragmatic paralysis, or superior vena cava syndrome.…”

“…Both increase morbidity. 1 The thymoma (T) according to its clinical stage determined by Masaoka classification, and classification of the world health organization (WHO), determines the treatment and prognosis; however, treatment of necrotizing pneumonia is less clear, partly due to absence of large studies that determine a standardized treatment, so it is referred to small case series. 2,3 The coexistence of two rare entities limits the therapeutic options due to the lack of standardization of treatment options with proven efficacy.…”