The role of tumor dimension among the different thymic tumor histologies: A European Society of Thoracic Surgeons thymic database analysis.

Abstract

Tumor size was recently proposed as a prognosticator in thymic tumors. The aim of this study is to investigate the prognostic role of tumor size in the different thymic tumor histologies. Clinical and pathologic data of patients from the European Society of Thoracic Surgeons thymic database who underwent surgery for thymic epithelial tumors from January 2000 to December 2022 were reviewed, analyzed, and correlated to overall survival and disease-free survival using Kaplan-Meier curves. The log-rank test was used to assess differences between subgroups. The final analysis was conducted on 2,556 patients. Histology results showed thymoma in 2,231 (87.3%), thymic carcinoma in 271 (10.6%), and neuroendocrine tumors in 54 (2.1%) cases. In 1,518 (59.4%) cases, size was >5 cm. The survival difference was significant considering thymoma and thymic carcinoma/neuroendocrine tumor. The 5-and 10-year disease-free survival rates were 85.4% and 78.1% vs 77.6% and 62.4% in ≤5 cm vs >5 cm thymomas (P < .001), and 5- and 10-year overall survival rates were 92.4% and 79.4% vs 88% and 74.5% in ≤5 cm vs >5 cm thymomas (P = .002). For thymic carcinoma/neuroendocrine tumor, the disease-free survival rate in the ≤5 cm group was 61.3% at both 5 and 10 years, compared with 53.3% and 46.9% in the >5 cm group, respectively (P = .042), whereas 5- and 10-year overall survival rates were 84.9% and 79.4% vs 74.9% and 64.9% in ≤5 cm vs >5 cm groups (P = .002). Tumor size was a significant prognosticator in thymic epithelial tumor, thymoma, and thymic carcinoma/neuroendocrine tumor, confirming its validity in prognosis prediction of these tumors.