The impact of thymoma histotype on prognosis in a worldwide database

Cleo Aron Weis, Xiaopan Yao, Yanhong Deng, Frank C. Detterbeck, Mirella Marino, Andrew G. Nicholson, James Huang, Philipp Ströbel, Alberto Antonicelli, Alexander Marx

Research output: Contribution to journalArticlepeer-review


INTRODUCTION:: The rarity of thymomas and lack of multi-institutional studies have hampered therapeutic progress for decades. To overcome this, the members of the International Thymic Malignancy Interest Group created a worldwide retrospective database. This database was analyzed regarding the demographic and geographic distribution of thymomas and the impact of different variables on survival and recurrence. METHODS:: This study analyzed 4221 thymomas diagnosed between 1983 and 2012 with World Health Organization histotype information from the International Thymic Malignancy Interest Group database. Associations to survival and recurrence were studied by univariate and multivariate analyses. RESULTS:: Type B2 thymoma is the most common (28%) and type A the least common (12%) histotypes. They are significantly more frequent in Europe and the United States than Asia. Type A and AB occur at significantly higher age than other thymomas (64 and 57 years, respectively). There are no differences in gender distribution. Stage is lower in type A (90% in stages I-II) and AB than B1 to B3 thymomas (38% of type B3 in stage III). In univariate analysis, recurrence is significantly less frequent among stage I/II tumors, in type A and AB (recurrence rates, 1-2%) than B1 to B3 thymomas (2-7%). Multivariate analysis reveals an impact of age, stage, and resection status on survival and recurrence, whereas for histology there is only a significant impact on recurrence. CONCLUSION:: New findings are (1) geographic differences such as a lower incidence of type A and B2 thymoma in Asia; and (2) impact of stage and histology, the latter partially limited to early stage disease, on recurrence.

Original languageEnglish
Pages (from-to)367-372
Number of pages6
JournalJournal of Thoracic Oncology
Issue number2
Publication statusPublished - Feb 6 2015


  • Epidemiology
  • International Thymic Malignancy Interest Group
  • Prognosis
  • Thymoma
  • World Health Organization histotype

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine


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