Investigating the Impact of Tumor Size on Survival Outcomes in Thymoma and Thymic Carcinoma Patients Using the SEER Database

Overview

Journal Sci Rep

Specialty Science

Date 2024 Nov 12

PMID 39533067

Authors

Yipeng Yin

Wei Wang

Mingbo Tang

Wei Liu

Affiliations

Soon will be listed here.

Abstract

This study aims to clarify the impact of tumor size on the prognosis of patients diagnosed with thymoma and thymic carcinoma, leveraging data from a population-based registry. Utilizing the SEER database, this retrospective analysis identified patients diagnosed with thymoma and thymic carcinoma from 2000 to 2020. Propensity score matching was employed to mitigate potential statistical biases between groups categorized by tumor size (≤ 6.5 cm and > 6.5 cm). The study included a total of 3857 patients, comprising 2688 with thymoma and 1169 with thymic carcinoma. Multivariate analysis demonstrated that tumors ≤ 6.5 cm independently correlated with improved Cancer-Specific Survival (CSS) (p = 0.001; p < 0.001) and Overall Survival (OS) (p < 0 .001; p < 0.001) in both thymoma and thymic carcinoma cohorts. Subgroup analysis revealed that smaller tumors (≤ 6.5 cm) conferred survival benefits in patients with Masaoka-Koga stage IIB thymomas and stage III/IV thymic carcinomas (thymoma: CSS: p < 0.0001; OS: p = 0.00045; thymic carcinoma: CSS: p = 0.028; OS: p = 0.014). Additionally, WHO type A/AB/B1 and type B2/B3 thymomas with tumors ≤ 6.5 cm exhibited superior CSS (p = 0.005; p < 0.00018) and OS (p = 0.015; p = 0.0021). Through propensity matching analysis utilizing the SEER database, this study underscores the prognostic significance of tumor size in both early-stage thymoma and advanced-stage thymic carcinoma, identifying a critical threshold of 6.5 cm. In the WHO classification, tumor size based on the cut-off value of 6.5 cm has a greater impact on the prognosis of type B2/B3 (high-risk group) than A/AB/B1 (low-risk group).

References

Chiappetta M, Sassorossi C, Lococo F, Margaritora S . Survival in Thymic Epithelial Tumors: The Size Matters-Comment on "Prognostic Impact of Number of Organ Invasions in Patients with Surgically Resected Thymoma". Ann Surg Oncol. 2023; 30(7):4058-4059. DOI: 10.1245/s10434-023-13433-3. View

Shao Y, Tang M, Fang L, Wei S, Gao X, Liu W . Prognostic value of tumor size in thymic epithelial tumors: A systematic review and meta-analysis. Medicine (Baltimore). 2022; 101(46):e31741. PMC: 9678511. DOI: 10.1097/MD.0000000000031741. View

Detterbeck F, Youssef S, Ruffini E, Okumura M . A review of prognostic factors in thymic malignancies. J Thorac Oncol. 2011; 6(7 Suppl 3):S1698-704. DOI: 10.1097/JTO.0b013e31821e7b12. View

Kuffer S, Muller D, Marx A, Strobel P . Non-Mutational Key Features in the Biology of Thymomas. Cancers (Basel). 2024; 16(5). PMC: 10931319. DOI: 10.3390/cancers16050942. View

Gomez D, Komaki R, Yu J, Ikushima H, Bezjak A . Radiation therapy definitions and reporting guidelines for thymic malignancies. J Thorac Oncol. 2011; 6(7 Suppl 3):S1743-8. DOI: 10.1097/JTO.0b013e31821ea60c. View

Von Der Thusen J . Thymic epithelial tumours: histopathological classification and differential diagnosis. Histopathology. 2023; 84(1):196-215. DOI: 10.1111/his.15097. View

Benveniste M, Korst R, Rajan A, Detterbeck F, Marom E . A practical guide from the International Thymic Malignancy Interest Group (ITMIG) regarding the radiographic assessment of treatment response of thymic epithelial tumors using modified RECIST criteria. J Thorac Oncol. 2014; 9(9 Suppl 2):S119-24. DOI: 10.1097/JTO.0000000000000296. View

Nicholson A, Detterbeck F, Marino M, Kim J, Stratton K, Giroux D . The IASLC/ITMIG Thymic Epithelial Tumors Staging Project: proposals for the T Component for the forthcoming (8th) edition of the TNM classification of malignant tumors. J Thorac Oncol. 2014; 9(9 Suppl 2):S73-80. DOI: 10.1097/JTO.0000000000000303. View

Utsumi T, Shiono H, Kadota Y, Matsumura A, Maeda H, Ohta M . Postoperative radiation therapy after complete resection of thymoma has little impact on survival. Cancer. 2009; 115(23):5413-20. DOI: 10.1002/cncr.24618. View

10.

Wright C, Wain J, Wong D, Donahue D, Gaissert H, Grillo H . Predictors of recurrence in thymic tumors: importance of invasion, World Health Organization histology, and size. J Thorac Cardiovasc Surg. 2005; 130(5):1413-21. DOI: 10.1016/j.jtcvs.2005.07.026. View

11.

Vogel J, Berman A, Lin L, Pechet T, Levin W, Gabriel P . Prospective study of proton beam radiation therapy for adjuvant and definitive treatment of thymoma and thymic carcinoma: Early response and toxicity assessment. Radiother Oncol. 2016; 118(3):504-9. DOI: 10.1016/j.radonc.2016.02.003. View

12.

Litvak A, Woo K, Hayes S, Huang J, Rimner A, Sima C . Clinical characteristics and outcomes for patients with thymic carcinoma: evaluation of Masaoka staging. J Thorac Oncol. 2014; 9(12):1810-5. PMC: 4663074. DOI: 10.1097/JTO.0000000000000363. View

13.

Ruffini E, Detterbeck F, Van Raemdonck D, Rocco G, Thomas P, Weder W . Tumours of the thymus: a cohort study of prognostic factors from the European Society of Thoracic Surgeons database. Eur J Cardiothorac Surg. 2014; 46(3):361-8. PMC: 4155438. DOI: 10.1093/ejcts/ezt649. View

14.

Myojin M, Choi N, Wright C, Wain J, Harris N, Hug E . Stage III thymoma: pattern of failure after surgery and postoperative radiotherapy and its implication for future study. Int J Radiat Oncol Biol Phys. 2000; 46(4):927-33. DOI: 10.1016/s0360-3016(99)00514-3. View

15.

Merveilleux du Vignaux C, Dansin E, Mhanna L, Greillier L, Pichon E, Kerjouan M . Systemic Therapy in Advanced Thymic Epithelial Tumors: Insights from the RYTHMIC Prospective Cohort. J Thorac Oncol. 2018; 13(11):1762-1770. DOI: 10.1016/j.jtho.2018.08.005. View

16.

Kayi Cangir A, Yenigun B, Direk T, Kocaman G, Yucemen U, Kahya Y . Different View on Tumor Size Dilemma in Tumor-Node-Metastasis Staging System for Thymoma. Thorac Cardiovasc Surg. 2020; 69(2):148-156. DOI: 10.1055/s-0040-1715490. View

17.

Fukui T, Fukumoto K, Okasaka T, Kawaguchi K, Nakamura S, Hakiri S . Prognostic impact of tumour size in completely resected thymic epithelial tumours. Eur J Cardiothorac Surg. 2016; 50(6):1068-1074. DOI: 10.1093/ejcts/ezw178. View

18.

Sassorossi C, Bertoglio P, Lococo F, Santoro G, Meacci E, Nachira D . Unsolved Issues in Thymic Epithelial Tumour Stage Classification: The Role of Tumour Dimension. Diagnostics (Basel). 2023; 13(22). PMC: 10670816. DOI: 10.3390/diagnostics13223468. View

19.

Rice D, Chansky K, Nowak A, Pass H, Kindler H, Shemanski L . The IASLC Mesothelioma Staging Project: Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma. J Thorac Oncol. 2016; 11(12):2100-2111. DOI: 10.1016/j.jtho.2016.09.121. View

20.

Rami-Porta R, Nishimura K, Giroux D, Detterbeck F, Cardillo G, Edwards J . The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groups in the Forthcoming (Ninth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol. 2024; 19(7):1007-1027. DOI: 10.1016/j.jtho.2024.02.011. View