Comparison of outcomes between neuroendocrine thymic tumours and other subtypes of thymic carcinomas: A joint analysis of the European Society of Thoracic Surgeons and the International Thymic Malignancy Interest Group

Pier Luigi Filosso, Xiaopan Yao, Enrico Ruffini, Usman Ahmad, Alberto Antonicelli, James Huang, Francesco Guerrera, Federico Venuta, Dirk van Raemdonck, William Travis, Marco Lucchi, Andreas Rimner, Pascal Thomas, Walter Weder, Gaetano Rocco, Frank Detterbeck, Robert Korst

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The latest World Health Organization (WHO) histological classification divides thymic epithelial tumours in thymomas and thymic carcinomas (TCs), the latter also including the neuroendocrine thymic tumours (NETTs). NETTs and other TC histotypes have been described to have a significantly lower survival than thymomas, but these two groups of tumours have rarely been compared directly. Using the European Society of Thoracic Surgeons and the International Thymic Malignancy Interest Group datasets, we wanted to study this issue. METHODS: This is a retrospective multicentre cohort study of patients operated for TC. Outcome measures were overall survival (OS) and recurrence-free survival (RFS). OS was analysed using the Kaplan-Meier method and RFS was assessed using competing risk analysis. The association with clinical and prognostic factors for OS and RFS was evaluated with log-rank test and Gray's test, respectively. RESULTS: A total of 1247 tumours (1042 TCs) were collected between 1984 and 2012. A R0 resection was performed in 363 TCs and in 52 NETTs. The median follow-up was 4.4 years for TCs and 4.1 years for NETTs. Owing to the missing values for survival information, a total of 728 TC patients and 132 NETTs were included in the OS analysis. Among them, 262 TC and 39 NETT patients died. The median OS was 6.6 years for TC and 7.5 years for NETTs. The overall 5-year survival rates were 60% for TC and 68% for NETTs; 10-year survival rates were 40% for TCs and 39% for NETTs (P = 0.19). Five-year RFS was 0.35 and 0.34 for TCs and NETTs (P = 0.36). On multivariate analysis, histology did not influence either OS (P = 0.79) or RFS (P = 0.59). CONCLUSIONS: This represents the largest clinical series of TCs and NETTs collected. Despite the biological aggressiveness of these rare neoplasms, the 5-year survival rate after resection is over 60% and TCs and NETT showed a similar rate of survival and recurrences after surgery.

Original languageEnglish
Pages (from-to)766-771
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume50
Issue number4
DOIs
Publication statusPublished - Oct 1 2016

Keywords

  • Histology
  • Surgery
  • Survival
  • Thymic carcinoma
  • Thymic epithelial tumours
  • Thymic neuroendocrine tumour
  • Thymus

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Comparison of outcomes between neuroendocrine thymic tumours and other subtypes of thymic carcinomas: A joint analysis of the European Society of Thoracic Surgeons and the International Thymic Malignancy Interest Group'. Together they form a unique fingerprint.

  • Cite this

    Filosso, P. L., Yao, X., Ruffini, E., Ahmad, U., Antonicelli, A., Huang, J., Guerrera, F., Venuta, F., van Raemdonck, D., Travis, W., Lucchi, M., Rimner, A., Thomas, P., Weder, W., Rocco, G., Detterbeck, F., & Korst, R. (2016). Comparison of outcomes between neuroendocrine thymic tumours and other subtypes of thymic carcinomas: A joint analysis of the European Society of Thoracic Surgeons and the International Thymic Malignancy Interest Group. European Journal of Cardio-thoracic Surgery, 50(4), 766-771. https://doi.org/10.1093/ejcts/ezw107