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The impact of thymoma histotype on prognosis in a worldwide database.

Weis CA, Yao X, Deng Y, Detterbeck FC, Marino M, Nicholson AG, Huang J, Ströbel P, Antonicelli A, Marx A, Contributors to the ITMIG Retrospective Databa - J Thorac Oncol (2015)

Bottom Line: They are significantly more frequent in Europe and the United States than Asia.There are no differences in gender distribution.Multivariate analysis reveals an impact of age, stage, and resection status on survival and recurrence, whereas for histology there is only a significant impact on recurrence.

View Article: PubMed Central - PubMed

Affiliation: *Institute of Pathology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany; †Section of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; ‡Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut; §Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy; ║Department of Histopathology, Royal Brompton Hospital, and National Heart and Lung Institute, Imperial College London, London, United Kingdom; ¶Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York; and #Institute of Pathology, University Medical Center Göttingen, University of Göttingen, Göttingen, Germany.

ABSTRACT

Introduction: The rarity of thymomas and lack of multi-institutional studies have hampered therapeutic progress for decades. To overcome this, the members of the International Thymic Malignancy Interest Group created a worldwide retrospective database. This database was analyzed regarding the demographic and geographic distribution of thymomas and the impact of different variables on survival and recurrence.

Methods: This study analyzed 4221 thymomas diagnosed between 1983 and 2012 with World Health Organization histotype information from the International Thymic Malignancy Interest Group database. Associations to survival and recurrence were studied by univariate and multivariate analyses.

Results: Type B2 thymoma is the most common (28%) and type A the least common (12%) histotypes. They are significantly more frequent in Europe and the United States than Asia. Type A and AB occur at significantly higher age than other thymomas (64 and 57 years, respectively). There are no differences in gender distribution. Stage is lower in type A (90% in stages I-II) and AB than B1 to B3 thymomas (38% of type B3 in stage III). In univariate analysis, recurrence is significantly less frequent among stage I/II tumors, in type A and AB (recurrence rates, 1-2%) than B1 to B3 thymomas (2-7%). Multivariate analysis reveals an impact of age, stage, and resection status on survival and recurrence, whereas for histology there is only a significant impact on recurrence.

Conclusion: New findings are (1) geographic differences such as a lower incidence of type A and B2 thymoma in Asia; and (2) impact of stage and histology, the latter partially limited to early stage disease, on recurrence.

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Stage distribution of thymoma histotypes. Stage classification as reported by the centers using either the Masaoka or Masoaka-Koga classification systems. WHO, World Health Organization.
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Figure 1: Stage distribution of thymoma histotypes. Stage classification as reported by the centers using either the Masaoka or Masoaka-Koga classification systems. WHO, World Health Organization.

Mentions: Characteristics of the 4221 thymoma cases are summarized in Supplementary Table S1 (SDC 1, http://links.lww.com/JTO/A732). There is no gender predilection (49% male and 51% female patients). The largest number of cases came from centers in Europe; center volume ranged from 461 to 2 patients. Demographic and clinical details specifically for each WHO histotype are shown in Table 1. There is no significant gender predilection among the five WHO types. Type A and AB patients are significantly older than B1-3 patients (median, 60 versus 52, p < 0.0001). Myasthenia gravis (MG) is more frequent in type B1-3 thymomas (35–49%) than in type A and AB (25–26%). There is a significant association between WHO type and stage (p < 0.0001, Fig. 1).


The impact of thymoma histotype on prognosis in a worldwide database.

Weis CA, Yao X, Deng Y, Detterbeck FC, Marino M, Nicholson AG, Huang J, Ströbel P, Antonicelli A, Marx A, Contributors to the ITMIG Retrospective Databa - J Thorac Oncol (2015)

Stage distribution of thymoma histotypes. Stage classification as reported by the centers using either the Masaoka or Masoaka-Koga classification systems. WHO, World Health Organization.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4318643&req=5

Figure 1: Stage distribution of thymoma histotypes. Stage classification as reported by the centers using either the Masaoka or Masoaka-Koga classification systems. WHO, World Health Organization.
Mentions: Characteristics of the 4221 thymoma cases are summarized in Supplementary Table S1 (SDC 1, http://links.lww.com/JTO/A732). There is no gender predilection (49% male and 51% female patients). The largest number of cases came from centers in Europe; center volume ranged from 461 to 2 patients. Demographic and clinical details specifically for each WHO histotype are shown in Table 1. There is no significant gender predilection among the five WHO types. Type A and AB patients are significantly older than B1-3 patients (median, 60 versus 52, p < 0.0001). Myasthenia gravis (MG) is more frequent in type B1-3 thymomas (35–49%) than in type A and AB (25–26%). There is a significant association between WHO type and stage (p < 0.0001, Fig. 1).

Bottom Line: They are significantly more frequent in Europe and the United States than Asia.There are no differences in gender distribution.Multivariate analysis reveals an impact of age, stage, and resection status on survival and recurrence, whereas for histology there is only a significant impact on recurrence.

View Article: PubMed Central - PubMed

Affiliation: *Institute of Pathology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany; †Section of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; ‡Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut; §Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy; ║Department of Histopathology, Royal Brompton Hospital, and National Heart and Lung Institute, Imperial College London, London, United Kingdom; ¶Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York; and #Institute of Pathology, University Medical Center Göttingen, University of Göttingen, Göttingen, Germany.

ABSTRACT

Introduction: The rarity of thymomas and lack of multi-institutional studies have hampered therapeutic progress for decades. To overcome this, the members of the International Thymic Malignancy Interest Group created a worldwide retrospective database. This database was analyzed regarding the demographic and geographic distribution of thymomas and the impact of different variables on survival and recurrence.

Methods: This study analyzed 4221 thymomas diagnosed between 1983 and 2012 with World Health Organization histotype information from the International Thymic Malignancy Interest Group database. Associations to survival and recurrence were studied by univariate and multivariate analyses.

Results: Type B2 thymoma is the most common (28%) and type A the least common (12%) histotypes. They are significantly more frequent in Europe and the United States than Asia. Type A and AB occur at significantly higher age than other thymomas (64 and 57 years, respectively). There are no differences in gender distribution. Stage is lower in type A (90% in stages I-II) and AB than B1 to B3 thymomas (38% of type B3 in stage III). In univariate analysis, recurrence is significantly less frequent among stage I/II tumors, in type A and AB (recurrence rates, 1-2%) than B1 to B3 thymomas (2-7%). Multivariate analysis reveals an impact of age, stage, and resection status on survival and recurrence, whereas for histology there is only a significant impact on recurrence.

Conclusion: New findings are (1) geographic differences such as a lower incidence of type A and B2 thymoma in Asia; and (2) impact of stage and histology, the latter partially limited to early stage disease, on recurrence.

Show MeSH
Related in: MedlinePlus