Long-term outcome and prognostic factors of surgically treated thymic carcinoma: results of 306 cases from a Japanese Nationwide Database Study

Hishida, Tomoyuki; Nomura, Shosaku; Yano, Motoki; Asamura, Hisao; Yamashita, Motohiro; Ohde, Yasuhisa; Kondo, Keishi; Date, Hiroshi; Okumura, Meinoshin; Nagai, Kanji

doi:10.1093/ejcts/ezv239

Cited by 117 publications

(108 citation statements)

References 24 publications

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“…The optimal cut-off value for PD-L1 expression was defined on the basis of the ROC curve and Youden index (28,29). Here, Masaoka-Koga stage and surgical curability were taken into account as variables that significantly affect prognosis (8,30). Ultimately, either Masaoka-Koga stage I/IIa/IIb/III disease who all performed complete resection or stage IVa/IVb who undergone diagnostic biopsy was applied as a dichotomous variable, with PD-L1 expression as a continuous variable.…”

Section: Appraisal Of Pd-l1 Expressionmentioning

confidence: 99%

Prognostic Value of Programmed Death Ligand 1 and Programmed Death 1 Expression in Thymic Carcinoma

Yokoyama

Miyoshi

Nakashima

et al. 2016

Clinical Cancer Research

115

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Purpose: The immune checkpoint of the programmed death 1/programmed death ligand 1 (PD-1/PD-L1) pathway is believed to play an important role in evasion of host antitumor immune surveillance in various malignancies; however, little is known about its role in thymic carcinoma. This study investigated PD-1/PD-L1 expression and its association with clinicopathologic features, the expression of immune-related proteins in tumor-infiltrating lymphocytes (TIL), and patient prognosis. Experimental Design: PD-L1 and PD-1 expression was evaluated by IHC in 25 thymic carcinoma tissue specimens. Copy number alterations of the PD-L1 gene in 11 cases were assessed in formalin-fixed, paraffin-embedded material using qRT-PCR. Results: Compared with normal subjects, 3 thymic carcinoma patients showed an increase in PD-L1 copy number, whereas 8 did not. PD-L1 was significantly overexpressed in cases with copy number gain as compared with normal cases. High PD-L1 expression was associated with higher disease-free and overall survival rates as compared to cases with low expression. Prognostic analysis revealed low PD-L1 expression and high number of PD-1+ TILs as significant predictors of poor survival, together with Masaoka–Koga stage IVa/IVb disease and incomplete resection. In the quantitative analysis of TILs, PD-L1 expression correlated proportionally with the number of infiltrating CTLs. Conclusions: Here, for the first time, we report that PD-L1 and PD-1 expression might be useful prognostic predictors in thymic carcinoma. Further studies are expected to substantiate the prognostic value of PD-L1 and PD-1 expression, and the potential efficacy of targeting the PD-1/PD-L1 pathway in thymic carcinoma via immunotherapy. Clin Cancer Res; 22(18); 4727–34. ©2016 AACR.

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Section: Appraisal Of Pd-l1 Expressionmentioning

confidence: 99%

Prognostic Value of Programmed Death Ligand 1 and Programmed Death 1 Expression in Thymic Carcinoma

Yokoyama

Miyoshi

Nakashima

et al. 2016

Clinical Cancer Research

115

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“…A previous report indicated that the incidence of nodal metastases in patients with thymic carcinoma was 26.8% (1). It has been confirmed by several studies that patients with thymic carcinoma receiving complete resection (R0) exhibit a more favorable long-term survival compared with those who undergo incomplete resection or do not receive surgery (1,5). …”

Section: Discussionmentioning

confidence: 93%

“…The majority of recurrences appear as pleural dissemination, mediastinal relapse, or both. Most thymic carcinomas present at an advanced stage and have a high frequency of relapse, even after complete resection, which indicates the need for a multidisciplinary therapeutic approach (5). Multidisciplinary therapy, including re-excision, radiotherapy and chemotherapy, is recommended.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of patients with thymic carcinoma present at an advanced stage and have a poor prognosis (1,2). However, a proportion of the patients who achieve long-term survival develop disease relapse and are candidates for salvage therapy, such as re-resection, radiotherapy, or other modalities (3–5). We herein present the 20-year clinical course of a patient initially diagnosed with stage IVb thymic carcinoma that developed bidirectional metastases toward the pleural and lymph nodes, which were successfully treated with repeated chemotherapy, surgery and radiotherapy, followed by low-dose steroid therapy.…”

Section: Introductionmentioning

confidence: 99%

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Successful treatment of advanced thymic carcinoma with lymph node and pleural metastases: A case report

Yamamoto

Kodama

Maniwa

et al. 2016

Molecular and Clinical Oncology

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Thymic carcinoma is a rare type of cancer that is more aggressive and is associated with a poorer prognosis compared with thymoma. No definitive clinical management of this disease has been established to date. This report describes the 20-year clinical course of a 50-year-old male patient who was successfully treated for initially diagnosed stage IVb thymic carcinoma. Thymo-thymectomy combined with resection of the surrounding organs was performed on December 1995 with curative intent (R0) after neoadjuvant chemoradiotherapy. From June 2008 until present, four pleural and subclavicular lymph node metastases have been treated with chemotherapy, radiotherapy and surgery, followed by low-dose oral steroid therapy. The patient has remained disease-free for the last 20 months since the initiation of prednisolone treatment. Thus, multidisciplinary treatment may achieve long-term survival in patients with stage IVb thymic carcinoma.

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“…Although the prognosis was more optimistic in MG without thymoma, both the clinical symptoms of MG and thymoma can be alleviated after thymectomy (Yu et al 2012). However, postoperative recurrence or metastasis is still inevitable and not uncommon (Hishida et al 2016), and few therapeutic options are available for effective treatment of relapsed or refractory thymoma (Simonelli et al 2015). Despite the recommendations for further resection, vast majority of patients will relapse again (Bott et al 2011).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Potential of Docetaxel plus Cisplatin Chemotherapy for Myasthenia Gravis Patients with Metastatic Thymoma

Liu

Hua

et al. 2017

Tohoku J. Exp. Med.

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The prognosis of myasthenia gravis (MG) in association with invasive or metastatic thymoma is usually worse, and therapeutic options are quite limited. Here, we retrospectively reported the therapeutic effect of docetaxel plus cisplatin (docetaxel/cisplatin) chemotherapy in 7 MG patients with metastatic thymoma. Previously, all patients underwent thymectomy at the first onset of thymoma. After the metastasis of thymoma, none of the patients received thymectomy due to unresectable conditions after surgeon's evaluation for great risk of myasthenic crisis (n = 5) or patients' refusal (n = 2). All patients received docetaxel (75 mg/m 2 ) and cisplatin (70 mg/m 2 ) on day 1 (d1) every 21 days, with the cycle ranging from 1 to 4. After docetaxel/cisplatin chemotherapy, one patient achieved partial response, and 6 with stable disease of the tumors. The clinical symptoms of MG were alleviated in all patients, 2 with complete remission and the other 5 with marked improvement. Myelosuppression was the major adverse event, occurring in 2 patients (grade II and IV). MG relapse occurred in one patient during the follow-up. Our study presented a series of MG patients with metastatic thymoma who underwent docetaxel/cisplatin chemotherapy. Besides the improved/stabilized thymoma, markedly improvement of MG with the tolerable adverse events was achieved. Docetaxel/cisplatin chemotherapy appears to be an effective treatment for selected patients with MG in association with unresectable metastatic thymoma. Further follow-up of these patients and additional subjects will be needed to determine whether the therapeutic benefits are durable.

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Long-term outcome and prognostic factors of surgically treated thymic carcinoma: results of 306 cases from a Japanese Nationwide Database Study

Cited by 117 publications

References 24 publications

Prognostic Value of Programmed Death Ligand 1 and Programmed Death 1 Expression in Thymic Carcinoma

Prognostic Value of Programmed Death Ligand 1 and Programmed Death 1 Expression in Thymic Carcinoma

Successful treatment of advanced thymic carcinoma with lymph node and pleural metastases: A case report

Therapeutic Potential of Docetaxel plus Cisplatin Chemotherapy for Myasthenia Gravis Patients with Metastatic Thymoma

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