A nomogram for predicting recurrence after complete resection for thymic epithelial tumors based on the TNM classification: A multi‐institutional retrospective analysis

Yun, Jae Kwang; Lee, Geun Dong; Kim, Hyeong Ryul; Kim, Dong Kwan; Zo, Jae Ill; Shim, Young Mog; Kang, Chang Hyun; Kim, Young Tae; Paik, Hyo Chae; Chung, Kyoung Young

doi:10.1002/jso.25462

Cited by 11 publications

(10 citation statements)

References 28 publications

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“…Our univariate Cox analysis showed that the TNM stage was a significant independent risk factor for 1-year HCC recurrence. The predictive ability of the TNM stage for tumor recurrence has already been assessed in several types of cancer, such as eyelid carcinoma [25], thymic epithelial tumors [26] and lung cancer [27], and a model has been established combining the TNM stage and tumor size to predict recurrence among HCC patients [28]. However, the AUC of the TNM stage to predict 1-year recurrence in our study demonstrated low predictive efficacy.…”

Section: Discussionmentioning

confidence: 69%

Integrated nomogram based on five stage-related genes and TNM stage to predict 1-year recurrence in hepatocellular carcinoma

et al. 2020

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Background: The primary tumor, regional lymph nodes and distant metastasis (TNM) stage is an independent risk factor for 1-year hepatocellular carcinoma (HCC) recurrence but has insufficient predictive efficiency. We attempt to develop and validate a nomogram to predict 1-year recurrence in HCC and improve the predictive efficiency of the TNM stage. Methods: A total of 541 HCC patients were enrolled in the study. The risk score (RS) model was established with the logistic least absolute shrinkage and selector operation algorithm. The predictive nomogram was further validated in the internal testing cohort and external validation cohort. The area under the receiver operating characteristic curves (AUCs), decision curves and clinical impact curves were used to evaluate the predictive accuracy and clinical value of the nomogram. Results: In the training cohort, we identified a RS model consisting of five stage-related genes (NUP62, EHMT2, RANBP1, MSH6 and FHL2) for recurrence at 1 year. The 1-year disease-free survival of patients was worse in the highrisk group than in the low-risk group (P < 0.0001), and 1-year recurrence was more likely in the high-risk group (Hazard ratio: 3.199, P < 0.001). The AUC of the nomogram was 0.739, 0.718 and 0.693 in the training, testing and external validation cohort, respectively, and these values were larger than the corresponding AUC of the TNM stage (0.681, 0.688 and 0.616, respectively). Conclusions: A RS model consisting of five stage-related genes was successfully identified for predicting 1-year HCC recurrence. Then, a novel nomogram based on the RS model and TNM stage to predict 1-year HCC recurrence was also developed and validated.

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Section: Discussionmentioning

confidence: 69%

Integrated nomogram based on five stage-related genes and TNM stage to predict 1-year recurrence in hepatocellular carcinoma

et al. 2020

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“…In this study analysis, the number of stage II patients was too small to be statistically analyzed and the TNM stage was not observed to be a strong prognostic factor in multivariable Cox analysis. However, another study based on the KART database showed that the TNM staging system was superior to the M-K staging system in terms of FFR [ 10 ]. There were statistically significant differences in OS between stage I and stage III and between stage I and stage IV (p<0.001).…”

Section: Discussionmentioning

confidence: 99%

An Overview of Surgical Treatment of Thymic Epithelial Tumors in Korea: A Retrospective Multicenter Analysis

Lee

Kim

et al. 2022

J Chest Surg

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Background Thymic epithelial tumors (TETs) are rare, and information regarding their surgical outcomes and prognostic factors has rapidly changed in the past few decades. We analyzed surgical treatment practices for TETs and outcomes in terms of overall survival (OS) and freedom from recurrence (FFR) during a 13-year period in Korea. Methods In total, 1,298 patients with surgically resected TETs between 2000 and 2013 were enrolled retrospectively. OS and FFR were calculated using the Kaplan-Meier method and evaluated with the log-rank test. Prognostic factors for OS and FFR were analyzed with multivariable Cox regression. Results A total of 1,098 patients were diagnosed with thymoma, and 200 patients were diagnosed with thymic carcinoma. Over the study period, the total number of patients with surgically treated TETs and the proportion of patients who underwent minimally invasive thymic surgery (MITS) increased annually. The 5-year and 10-year survival rates of surgically treated TETs were 91.0% and 82.1%, respectively. The 5-year and 10-year recurrence rates were 86.3% and 80.0%, respectively. The outcomes of surgically treated TETs improved over time. Multivariable Cox hazards analysis for OS, age, tumor size, and Masaoka-Koga stage were independent predictors of prognosis. The World Health Organization classification and tumor-node-metastasis (TNM) staging were also related to the prognosis of TETs. Conclusion Surgical treatment of TETs achieved a good prognosis with a recent increase in MITS. The M-K stage was the most important prognostic factor for OS and FFR. The new TNM stage could also be an effective predictor of the outcomes of TETs.

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“…Numerous studies have demonstrated the importance of clinicopathological features as predictive factors for survival outcomes, including age, 27,28 tumor length/diameter, 5,18 tumor stage, 10,29 and WHO type. 7,29 Therefore, novel parameters have been explored to achieve a clear understanding of the prognostic factors of TETs and improve survival outcomes. 8,9,30 In this present study, we first reported that the pathological tumor L/S ratio was a prognostic factor for survival outcomes in TETs.…”

Section: Discussionmentioning

confidence: 99%

Pathological tumor long‐to‐short axis ratio as a prognostic factor in patients with thymic epithelial tumors

et al. 2022

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Background: Thymic epithelial tumors (TETs) exhibit irregular shapes reflective of the heterogeneity in tumor growth and invasive properties. We aimed to identify the prognostic value of the pathological tumor long-to-short axis (L/S) ratio in TETs. Methods: A retrospective study was performed on patients with TETs who underwent extended thymectomy between January 1999 and December 2019 in our institute. Patients were divided into two groups according to the threshold of the L/S ratio. Overall survival (OS) and progression-free survival (PFS) were evaluated by Kaplan-Meier analysis. The independent prognostic factors of TETs were identified by multivariate analysis. The performance of prediction models for the above survival outcomes with and without the L/S ratio was evaluated using an integrated time-dependent area under the curve (iAUC). Results: Eligible patients were divided into two groups based on higher (n = 42) and lower (n = 94) L/S ratios according to a threshold value of 1.39. A significant difference was found between the two groups only in disease progression (p = 0.001). Poorer survival outcomes were found from Kaplan-Meier curves in the higher L/S ratio group (p < 0.05). In the multivariable analysis, the L/S ratio showed significant effects on OS and PFS (p < 0.05). The performance of models with the L/S ratio was better than that without the L/S ratio in predicting survival outcomes. Conclusions: The pathological tumor L/S ratio is an independent prognostic factor for OS and PFS in patients with TETs, and an L/S ratio >1.39 is associated with worse survival outcomes.

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A nomogram for predicting recurrence after complete resection for thymic epithelial tumors based on the TNM classification: A multi‐institutional retrospective analysis

Cited by 11 publications

References 28 publications

Integrated nomogram based on five stage-related genes and TNM stage to predict 1-year recurrence in hepatocellular carcinoma

Integrated nomogram based on five stage-related genes and TNM stage to predict 1-year recurrence in hepatocellular carcinoma

An Overview of Surgical Treatment of Thymic Epithelial Tumors in Korea: A Retrospective Multicenter Analysis

Pathological tumor long‐to‐short axis ratio as a prognostic factor in patients with thymic epithelial tumors

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