Limits...
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.

Show MeSH

Related in: MedlinePlus

Recurrence by thymoma histotype for specific stage groups. Cumulative incidence of recurrence by World Health organization (WHO) type (R0 patients) for (A) stages I + II, (B) stage III, and (C) stage IVa. Curves for stage IVb are not shown due to low case numbers. The table inserted in (A) shows pairwise comparisons for stages I + II with adjusted p values, asterisk denotes p ≤ 0.05. Data for stages III and IVa are not shown because all results are nonsignificant.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4318643&req=5

Figure 3: Recurrence by thymoma histotype for specific stage groups. Cumulative incidence of recurrence by World Health organization (WHO) type (R0 patients) for (A) stages I + II, (B) stage III, and (C) stage IVa. Curves for stage IVb are not shown due to low case numbers. The table inserted in (A) shows pairwise comparisons for stages I + II with adjusted p values, asterisk denotes p ≤ 0.05. Data for stages III and IVa are not shown because all results are nonsignificant.

Mentions: The effect of WHO subtype on recurrence within each stage group in R0 resected patients is shown in Figure 3A–C, to eliminate the effect of stage and resection status (corresponding data for survival are shown in Supplementary Figure S4, SDC 5, http://links.lww.com/JTO/A736). Thymoma histotype was a prognostic factor in stages I to II (1473 cases, R0); the CIR was significantly lower for type A, AB, and B2 versus B1 and B3 thymomas (5-year recurrence rates: type A 2%, [CI, 0.3–6%]; type AB 1% [0.4–3%]; B2 2% [0.8–4%] versus type B1 6% [3–10%]; and type B3 7% [3–12%]). By contrast, CIR was not significantly different between thymoma histotypes within stages III (277 cases, R0) and IVa (89 cases, R0).


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)

Recurrence by thymoma histotype for specific stage groups. Cumulative incidence of recurrence by World Health organization (WHO) type (R0 patients) for (A) stages I + II, (B) stage III, and (C) stage IVa. Curves for stage IVb are not shown due to low case numbers. The table inserted in (A) shows pairwise comparisons for stages I + II with adjusted p values, asterisk denotes p ≤ 0.05. Data for stages III and IVa are not shown because all results are nonsignificant.
© Copyright Policy
Related In: Results  -  Collection

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

Figure 3: Recurrence by thymoma histotype for specific stage groups. Cumulative incidence of recurrence by World Health organization (WHO) type (R0 patients) for (A) stages I + II, (B) stage III, and (C) stage IVa. Curves for stage IVb are not shown due to low case numbers. The table inserted in (A) shows pairwise comparisons for stages I + II with adjusted p values, asterisk denotes p ≤ 0.05. Data for stages III and IVa are not shown because all results are nonsignificant.
Mentions: The effect of WHO subtype on recurrence within each stage group in R0 resected patients is shown in Figure 3A–C, to eliminate the effect of stage and resection status (corresponding data for survival are shown in Supplementary Figure S4, SDC 5, http://links.lww.com/JTO/A736). Thymoma histotype was a prognostic factor in stages I to II (1473 cases, R0); the CIR was significantly lower for type A, AB, and B2 versus B1 and B3 thymomas (5-year recurrence rates: type A 2%, [CI, 0.3–6%]; type AB 1% [0.4–3%]; B2 2% [0.8–4%] versus type B1 6% [3–10%]; and type B3 7% [3–12%]). By contrast, CIR was not significantly different between thymoma histotypes within stages III (277 cases, R0) and IVa (89 cases, R0).

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