Stage-related outcome for thymic epithelial tumours

Abstract

Background: Thymic epithelial tumours (TETs) are characterized by a wide variety of biological behaviors. Radical resection and stage are strong prognostic factors. Aim of this study is to review our Single Center Experience. Methods: One hundred and seventy-seven patients observed in the period from January 2000 to December 2016 were included in the study. Data regarding clinicopathologic features, treatment, and survival were collected. Stagerelated clinical standpoints and therapeutic options were also evaluated. Results: Non-surgical treatment was primarily performed in 15 (8.47%), unresectable disease was intraoperatively found in 12 cases (7.4%). The analysis of 150 patients undergoing curative surgery revealed 70 stage I TET (46.66%), 49 stage II (32.66%), 19 stage III (12.66%), 6 stage IVa (4%) and 6 stage IVb (4%) at the first hospital admission. Histology identified 12 A thymoma (8%), 38 AB (25.33%), 24 B1 (16%), 50 B2 (33.33%), 19 B3 (12.66%) and 7 carcinomas (4.66%). The mean follow up time was 84.14 months (sd = 61.68 months). Disease relapse occurred in 13 patients (8.78%) at a mean period of 78.85 months (sd = 60.87 months) after surgery. Exitus due to thymoma happened in 6 cases (4.05%) after a mean survival of 56.02 months (sd = 25.17 months). The 5-year overall survival rate was 0.94 (95%CI 0.88-0.97) and the 5-year disease-free survival rate was 0.90 (95%CI 0.83-0.94). The 5-year overall survival rates were 96.1% (95% CI, 89.9-98.5%) for the early stages and 87.4% (95% CI, 65.6-95.8%) for the advanced stages (p = 0.670). The 5-year disease-free survival rates resulted being 98.8% (95% CI, 92.3-99.8%) for the early stages and 59.8% (95% CI, 37.8-76.2%) for the advanced stages (p < 0.001). Conclusions: Advanced stage TETs are characterized by higher mortality and recurrence rates. Although technically demanding, surgery, as part of multimodality therapy, could prolong survival. Iterative surgical treatment of recurrences is a viable option for selected patients. Trial registration: The study was approved by the Institutional Review Board of Perugia and Terni University Hospitals [Code T1003] and was retrospectively registered.

Management and Long-Term Outcomes of Advanced Stage Thymoma in the United States

“…It is well established that surgical resection is the mainstay of thymoma treatment, and can improve survival even in patients with stage IV disease. 15,16 We found that this was reflected in real-world practice, with treatment approaches including surgical resection being the most common for both stage III and IV thymoma in the United States. Surgical resection was often one component of multimodality therapy.…”

Thymic epithelial tumours in 51 dogs: Histopathologic and clinicopathologic findings

“…TET stage is prognostic in both humans and dogs, independent of histologic subtype. 4,19 The most widely used staging system for human TETs, also assessed in dogs, 4 is the Masaoka-Koga system which utilises both surgical and histologic information (Table 2) [20][21][22] although newer tumour, node, metastasis systems may provide more clinically relevant differentiation between stages. 23 Treatment of TETs primarily involves surgical excision.…”

Thymoma Presenting as a Pleural-Based Mass

“…Given the minimal tumor remnants seen after surgical resection for a Stage 3 thymoma due to its invasion into the surrounding tissue, adjuvant therapy such as radiotherapy or chemotherapy is recommended. If conditions for a possible macroscopically complete resection for a Stage 4 thymoma are not completely achievable, any surgical therapy plan should be avoided due to the fact that extended resections for Stage 3 and 4 thymomas can be technically demanding and have a high associated morbidity [ 8 ].…”