Thymic epithelial tumors: Do we know all the prognostic factors?

Abstract

Background Thymic epithelial tumors constitute a morphologically and clinically diverse group of rare neoplasm of the anterior mediastinum. Methods Here, we present an analysis of 188 patients diagnosed with primary thymic tumors between 1995 and 2015. The prognostic value of selected clinical and morphological factors was assessed in relation to overall survival and recurrence‐free survival. Results The risk of recurrence increased significantly in thymic carcinoma diagnosis (P = 0.0036), co‐occurrence of other diseases, and weight loss (P = 0.0012 and 0.0348, respectively). Multivariate analysis showed that the most important independent risk factor for disease recurrence was clinical stage IV (P = 0.0036). A total of 63 patients (33.5%) died. In the univariate analysis, the following factors were considered as independent prognostic factors for overall survival: clinical stage (P < 0.0001), histological type (P < 0.0001), lymph node involvement (P < 0.001), WHO performance status 2 (P < 0.0001), anemia (Hb <9.5 g/dL; P = 0.0002), leucocytosis (>12.5 G/L; P = 0.0011), LDH level (>185 U/L; P < 0.0001), concomitant diseases (P = 0.0012) and weight loss (P < 0.0001).The strongest independent risk factor for death was stage IV disease (P < 0.001). Conclusions The results confirmed a fairly good prognosis for patients with thymic epithelial tumors. Clinical stage was the most important prognostic factor, but, some additional clinical factors may also have prognostic value.

The Studies of Prognostic Factors and the Genetic Polymorphism of Methylenetetrahydrofolate Reductase C667T in Thymic Epithelial Tumors

“…In our study, the cut-off time was 2020-12-31, and therefore, the 2015 WHO histological classification system was used in this study. Our results demonstrated that this classification was associated with the OS of TET patients, but was not an independent prognostic factor by Cox multivariate survival analysis, which was consistent with previous studies ( 33 , 34 ). An increased WHO histological grade showed more malignant behavior and was associated with a poor prognosis ( 33 ).…”

Prognostic factors and outcome in cats with thymic epithelial tumours: 64 cases (1999‐2021)

“…Secondly, there is marked interobserver variation when assigning the histological subtypes in human TET (Dawson et al ., 1994, Detterbeck, 2006, Verghese et al ., 2008). Nevertheless, most human studies show that thymic carcinoma has the worst survival, but whether this has independent prognostic significance is unclear (Kondo et al ., 2004, Rea et al ., 2004, Rieker et al ., 2008, Weissferdt & Moran, 2015, Knetki‐Wróblewska et al ., 2021). These histologic subtypes have not demonstrated prognostic significance in dogs (Burgess et al ., 2016; Yale et al ., 2021).…”

Prognostic value of tumor size in thymic epithelial tumors: A systematic review and meta-analysis

“…A total of 8 studies [8][9][10][11][12][14][15][16] explored the relationship between tumor size and patient OS included 3163 patients. Pooled results (Fig.…”

“…The study characteristics of the 9 recruited articles are summarized in Table 1. HRs with 95% CIs regarding tumor size on OS could be obtained from 8 studies [8][9][10][11][12][14][15][16] directly and HRs with 95% CIs regarding tumor size on RFS could be obtained from 6 studies [8,[10][11][12][13]15] directly. Of the 9 studies we included, the study by Liu et al [14] was only on TC, the study by Okumura et al [13] was only on thymoma, and the other 7 studies were on TETs (both thymoma and TC).…”

“…After screening by our inclusion and exclusion criteria, a total of 9 studies [8][9][10][11][12][13][14][15][16] were selected for inclusion in our meta-analysis included 5246 patients (Fig. 1).…”