Thymic carcinoma: a cohort study of patients from the European society of thoracic surgeons database

Enrico Ruffini, Frank Detterbeck, Dirk Van Raemdonck, Gaetano Rocco, Pascal Thomas, Walter Weder, Alessandro Brunelli, Francesco Guerrera, Shaf Keshavjee, Nasser Altorki, Jan Schützner, Alex Arame, Lorenzo Spaggiari, Eric Lim, Alper Toker, Federico Venuta

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Thymic carcinoma is a rare and aggressive thymic neoplasm. The European Society of Thoracic Surgeons developed a retrospective database collecting patients undergoing resection for thymic tumors from 1990 to 2010.

METHODS: Of 2265 patients with thymic tumors, there were 229 thymic carcinomas. Clinicopathological characteristics were analyzed including age, associated paraneoplastic diseases, stage (Masaoka-Koga), World Health Organization histologic subtypes, type of resection (total/subtotal/biopsy/no resection), tumor size, pre/postoperative treatments, and recurrence. Outcome measures included overall survival (OS), freedom from recurrence, and cumulative incidence of recurrence.

RESULTS: A complete resection was achieved in 140 patients (69%). Recurrence occurred in 54 patients (28%). Five- and 10-year OS rates were 0.61 and 0.37. Five- and 10-year freedom from recurrence rates were 0.60 and 0.43. Cumulative incidence of recurrence was 0.21 (3 yr), 0.27 (5 yr), and 0.32 (10 yr). Survival was better after surgical resection versus biopsy/no resection (p <0.001), after complete resection versus subtotal resection (p <0.001), and when using Masaoka-Koga system (stages I-II versus III versus IV) (p <0.001). The use of multidisciplinary treatments resulted in a survival advantage which was significant in the surgery + radiotherapy group (p = 0.02). Incomplete resection (p <0.0001) and advanced stage (Masaoka-Koga III-IV) (p = 0.02) had a negative impact on OS at multivariable analysis. Administration of adjuvant radiotherapy was beneficial in increasing OS (p = 0.02).

CONCLUSIONS: The results of our study indicate that patients with thymic carcinoma should undertake surgical resection whenever possible; a complete resection and early Masaoka-Koga stage are independent predictors of improved survival; our results also suggest that postoperative radiotherapy is beneficial in improving survival.

Original languageEnglish
Pages (from-to)541-548
Number of pages8
JournalJournal of Thoracic Oncology
Volume9
Issue number4
DOIs
Publication statusPublished - Apr 1 2014

Fingerprint

Thymoma
Cohort Studies
Thorax
Databases
Thymus Neoplasms
Survival
Recurrence
Radiotherapy
Biopsy
Adjuvant Radiotherapy
Incidence
Surgeons
Survival Rate
Outcome Assessment (Health Care)
Therapeutics
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Thymic carcinoma : a cohort study of patients from the European society of thoracic surgeons database. / Ruffini, Enrico; Detterbeck, Frank; Van Raemdonck, Dirk; Rocco, Gaetano; Thomas, Pascal; Weder, Walter; Brunelli, Alessandro; Guerrera, Francesco; Keshavjee, Shaf; Altorki, Nasser; Schützner, Jan; Arame, Alex; Spaggiari, Lorenzo; Lim, Eric; Toker, Alper; Venuta, Federico.

In: Journal of Thoracic Oncology, Vol. 9, No. 4, 01.04.2014, p. 541-548.

Research output: Contribution to journalArticle

Ruffini, E, Detterbeck, F, Van Raemdonck, D, Rocco, G, Thomas, P, Weder, W, Brunelli, A, Guerrera, F, Keshavjee, S, Altorki, N, Schützner, J, Arame, A, Spaggiari, L, Lim, E, Toker, A & Venuta, F 2014, 'Thymic carcinoma: a cohort study of patients from the European society of thoracic surgeons database', Journal of Thoracic Oncology, vol. 9, no. 4, pp. 541-548. https://doi.org/10.1097/JTO.0000000000000128
Ruffini, Enrico ; Detterbeck, Frank ; Van Raemdonck, Dirk ; Rocco, Gaetano ; Thomas, Pascal ; Weder, Walter ; Brunelli, Alessandro ; Guerrera, Francesco ; Keshavjee, Shaf ; Altorki, Nasser ; Schützner, Jan ; Arame, Alex ; Spaggiari, Lorenzo ; Lim, Eric ; Toker, Alper ; Venuta, Federico. / Thymic carcinoma : a cohort study of patients from the European society of thoracic surgeons database. In: Journal of Thoracic Oncology. 2014 ; Vol. 9, No. 4. pp. 541-548.
@article{4b793d811df943c4975bec65fe3eb364,
title = "Thymic carcinoma: a cohort study of patients from the European society of thoracic surgeons database",
abstract = "INTRODUCTION: Thymic carcinoma is a rare and aggressive thymic neoplasm. The European Society of Thoracic Surgeons developed a retrospective database collecting patients undergoing resection for thymic tumors from 1990 to 2010.METHODS: Of 2265 patients with thymic tumors, there were 229 thymic carcinomas. Clinicopathological characteristics were analyzed including age, associated paraneoplastic diseases, stage (Masaoka-Koga), World Health Organization histologic subtypes, type of resection (total/subtotal/biopsy/no resection), tumor size, pre/postoperative treatments, and recurrence. Outcome measures included overall survival (OS), freedom from recurrence, and cumulative incidence of recurrence.RESULTS: A complete resection was achieved in 140 patients (69{\%}). Recurrence occurred in 54 patients (28{\%}). Five- and 10-year OS rates were 0.61 and 0.37. Five- and 10-year freedom from recurrence rates were 0.60 and 0.43. Cumulative incidence of recurrence was 0.21 (3 yr), 0.27 (5 yr), and 0.32 (10 yr). Survival was better after surgical resection versus biopsy/no resection (p <0.001), after complete resection versus subtotal resection (p <0.001), and when using Masaoka-Koga system (stages I-II versus III versus IV) (p <0.001). The use of multidisciplinary treatments resulted in a survival advantage which was significant in the surgery + radiotherapy group (p = 0.02). Incomplete resection (p <0.0001) and advanced stage (Masaoka-Koga III-IV) (p = 0.02) had a negative impact on OS at multivariable analysis. Administration of adjuvant radiotherapy was beneficial in increasing OS (p = 0.02).CONCLUSIONS: The results of our study indicate that patients with thymic carcinoma should undertake surgical resection whenever possible; a complete resection and early Masaoka-Koga stage are independent predictors of improved survival; our results also suggest that postoperative radiotherapy is beneficial in improving survival.",
author = "Enrico Ruffini and Frank Detterbeck and {Van Raemdonck}, Dirk and Gaetano Rocco and Pascal Thomas and Walter Weder and Alessandro Brunelli and Francesco Guerrera and Shaf Keshavjee and Nasser Altorki and Jan Sch{\"u}tzner and Alex Arame and Lorenzo Spaggiari and Eric Lim and Alper Toker and Federico Venuta",
year = "2014",
month = "4",
day = "1",
doi = "10.1097/JTO.0000000000000128",
language = "English",
volume = "9",
pages = "541--548",
journal = "Journal of Thoracic Oncology",
issn = "1556-0864",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Thymic carcinoma

T2 - a cohort study of patients from the European society of thoracic surgeons database

AU - Ruffini, Enrico

AU - Detterbeck, Frank

AU - Van Raemdonck, Dirk

AU - Rocco, Gaetano

AU - Thomas, Pascal

AU - Weder, Walter

AU - Brunelli, Alessandro

AU - Guerrera, Francesco

AU - Keshavjee, Shaf

AU - Altorki, Nasser

AU - Schützner, Jan

AU - Arame, Alex

AU - Spaggiari, Lorenzo

AU - Lim, Eric

AU - Toker, Alper

AU - Venuta, Federico

PY - 2014/4/1

Y1 - 2014/4/1

N2 - INTRODUCTION: Thymic carcinoma is a rare and aggressive thymic neoplasm. The European Society of Thoracic Surgeons developed a retrospective database collecting patients undergoing resection for thymic tumors from 1990 to 2010.METHODS: Of 2265 patients with thymic tumors, there were 229 thymic carcinomas. Clinicopathological characteristics were analyzed including age, associated paraneoplastic diseases, stage (Masaoka-Koga), World Health Organization histologic subtypes, type of resection (total/subtotal/biopsy/no resection), tumor size, pre/postoperative treatments, and recurrence. Outcome measures included overall survival (OS), freedom from recurrence, and cumulative incidence of recurrence.RESULTS: A complete resection was achieved in 140 patients (69%). Recurrence occurred in 54 patients (28%). Five- and 10-year OS rates were 0.61 and 0.37. Five- and 10-year freedom from recurrence rates were 0.60 and 0.43. Cumulative incidence of recurrence was 0.21 (3 yr), 0.27 (5 yr), and 0.32 (10 yr). Survival was better after surgical resection versus biopsy/no resection (p <0.001), after complete resection versus subtotal resection (p <0.001), and when using Masaoka-Koga system (stages I-II versus III versus IV) (p <0.001). The use of multidisciplinary treatments resulted in a survival advantage which was significant in the surgery + radiotherapy group (p = 0.02). Incomplete resection (p <0.0001) and advanced stage (Masaoka-Koga III-IV) (p = 0.02) had a negative impact on OS at multivariable analysis. Administration of adjuvant radiotherapy was beneficial in increasing OS (p = 0.02).CONCLUSIONS: The results of our study indicate that patients with thymic carcinoma should undertake surgical resection whenever possible; a complete resection and early Masaoka-Koga stage are independent predictors of improved survival; our results also suggest that postoperative radiotherapy is beneficial in improving survival.

AB - INTRODUCTION: Thymic carcinoma is a rare and aggressive thymic neoplasm. The European Society of Thoracic Surgeons developed a retrospective database collecting patients undergoing resection for thymic tumors from 1990 to 2010.METHODS: Of 2265 patients with thymic tumors, there were 229 thymic carcinomas. Clinicopathological characteristics were analyzed including age, associated paraneoplastic diseases, stage (Masaoka-Koga), World Health Organization histologic subtypes, type of resection (total/subtotal/biopsy/no resection), tumor size, pre/postoperative treatments, and recurrence. Outcome measures included overall survival (OS), freedom from recurrence, and cumulative incidence of recurrence.RESULTS: A complete resection was achieved in 140 patients (69%). Recurrence occurred in 54 patients (28%). Five- and 10-year OS rates were 0.61 and 0.37. Five- and 10-year freedom from recurrence rates were 0.60 and 0.43. Cumulative incidence of recurrence was 0.21 (3 yr), 0.27 (5 yr), and 0.32 (10 yr). Survival was better after surgical resection versus biopsy/no resection (p <0.001), after complete resection versus subtotal resection (p <0.001), and when using Masaoka-Koga system (stages I-II versus III versus IV) (p <0.001). The use of multidisciplinary treatments resulted in a survival advantage which was significant in the surgery + radiotherapy group (p = 0.02). Incomplete resection (p <0.0001) and advanced stage (Masaoka-Koga III-IV) (p = 0.02) had a negative impact on OS at multivariable analysis. Administration of adjuvant radiotherapy was beneficial in increasing OS (p = 0.02).CONCLUSIONS: The results of our study indicate that patients with thymic carcinoma should undertake surgical resection whenever possible; a complete resection and early Masaoka-Koga stage are independent predictors of improved survival; our results also suggest that postoperative radiotherapy is beneficial in improving survival.

UR - http://www.scopus.com/inward/record.url?scp=84908450550&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908450550&partnerID=8YFLogxK

U2 - 10.1097/JTO.0000000000000128

DO - 10.1097/JTO.0000000000000128

M3 - Article

C2 - 24736078

AN - SCOPUS:84908450550

VL - 9

SP - 541

EP - 548

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

SN - 1556-0864

IS - 4

ER -