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Journal of B.U.ON. : Official Journal... 2021Thymic epithelial tumors represent 0.2-1.5% among all malignant neoplasms. They are slow-growing tumors with an overall recurrence rate around 10% and 90% of them are... (Review)
Review
Thymic epithelial tumors represent 0.2-1.5% among all malignant neoplasms. They are slow-growing tumors with an overall recurrence rate around 10% and 90% of them are located in the anterior mediastinum. In this review we focused on the classification, histopathology, molecular pathology and prognosis of thymic epithelial tumors, mainly thymoma and thymic carcinoma.
Topics: Carcinoma; Humans; Neoplasms, Glandular and Epithelial; Prognosis; Thymoma; Thymus Neoplasms
PubMed: 34564969
DOI: No ID Found -
Cancer Medicine Mar 2023Immunotherapy has exhibited efficacy in thymic carcinoma patients; however, there are insufficient data to confirm this efficacy in thymoma. The toxicity of...
BACKGROUND
Immunotherapy has exhibited efficacy in thymic carcinoma patients; however, there are insufficient data to confirm this efficacy in thymoma. The toxicity of immunotherapy also remains to be determined.
METHODS
The efficacy and safety of immunotherapy were analyzed in 11 thymoma patients who received PD-1 inhibitors according to a range of relevant indexes including the objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and immunotherapy-related adverse events.
RESULTS
The PFS and OS rates for all patients were 12.8 and 56.5 months, respectively. No difference in efficacy was detected between monotherapy and combination therapy (PFS: 12.8 vs 2.2 months, P = 0.787; OS: 73.8 vs 56.5 months, P = 0.367). The ORRs and DCRs for all patients were 27.3% and 90.9%, respectively. The incidence of adverse events was 45.5% among the 11 thymoma patients, including immune-related myocarditis (36.4%), immune-related liver damage (18.2%), and myasthenia gravis (18.2%). In the whole cohort of patients, the rate of adverse events of grade 3 or higher was 36.4%. The rates of adverse events of grade 3 or 4 in B3-type and non-B3-type thymoma patients were 0% and 62.5%, respectively.
CONCLUSIONS
Immunotherapy elicited a response in thymoma patients; however, more attention should be paid to the immune-related adverse events.
Topics: Humans; Thymoma; Thymus Neoplasms; Combined Modality Therapy; Immunotherapy
PubMed: 36394097
DOI: 10.1002/cam4.5357 -
Journal of Thoracic Oncology : Official... Dec 2023A TNM-based system for all types of thymic epithelial tumors was introduced in the eighth edition of the TNM classification of thoracic malignancies. The Thymic Domain...
The International Association for the Study of Lung Cancer Thymic Epithelial Tumors Staging Project: Proposal for a Stage Classification for the Forthcoming (Ninth) Edition of the TNM Classification of Malignant Tumors.
INTRODUCTION
A TNM-based system for all types of thymic epithelial tumors was introduced in the eighth edition of the TNM classification of thoracic malignancies. The Thymic Domain of the Staging and Prognostic Factors Committee of the International Association for the Study of Lung Cancer, composed of multispecialty international experts, was charged to develop proposals for the ninth edition. This article outlines the proposed definitions for the T, the N, and the M components and their combination into stage groups.
METHODS
A large central database of 11,347 patients with thymic epithelial tumors was assembled thanks to the contribution of the major thymic organizations worldwide and analyses were carried out for the T, the N, and the M components and the stage groups. Overall survival was the outcome measure for patients with completely and incompletely resected tumors, and recurrence for those with complete resection. When the number of patients was sufficient, analyses were performed separately for thymomas, thymic carcinomas, and neuroendocrine thymic tumors.
RESULTS
Tumor size is included in the T1 category as T1a (≤5cm) and T1b (>5 cm); the mediastinal pleura is dropped as a T descriptor; invasion of the lung or phrenic nerve is reclassified as T2 (instead of T3). No changes are proposed for the N and the M components from the eighth edition. The stage groups remain the same.
CONCLUSIONS
The proposed changes for the ninth edition of the TNM classification set the stage for further progress in the future for these rare tumors.
Topics: Humans; Neoplasm Staging; Lung Neoplasms; Prognosis; Myeloma Proteins; Thymus Neoplasms; Thymoma; Neuroendocrine Tumors; Neoplasms, Glandular and Epithelial
PubMed: 37689391
DOI: 10.1016/j.jtho.2023.09.002 -
Thoracic Cancer May 2021Thymomas and thymic carcinomas are the most common tumor types among anterior mediastinal lesions. However, the relationship between molecular aberrations and thymoma...
BACKGROUND
Thymomas and thymic carcinomas are the most common tumor types among anterior mediastinal lesions. However, the relationship between molecular aberrations and thymoma patients are poorly understood, especially abnormal changes in the expression profiles of circRNAs. The purpose of the present study was to investigate the expression profiles of circRNAs in thymoma patients and their possible roles in the pathogenesis of thymoma.
METHODS
Diseased tissues and surrounding normal thymic tissues in two thymoma patients were collected for circRNA sequencing. The top four upregulated circRNAs were selected as candidates and further validated with RT-PCR in 20 thymoma patients. Gene ontology and signal transduction network analyses of circRNA-related mRNAs were performed to analyze the functional properties. Survival analysis of their parental genes were also carried out to evaluate the clinical value of differentially expressed circRNA.
RESULTS
A total of 73 circRNAs were differentially expressed in thymoma tissues using high-throughput sequencing. Among these circRNAs, hsa_circ_0001173, hsa_circ_0007291, hsa_circ_0003550, and hsa_circ_0001947 were significantly upregulated in thymoma tissues compared with normal thymic tissues. We identified that these four circRNA-related mRNAs were involved in cell-cell adhesion, MAPK pathways, and TNF pathway, which may contribute to the pathological immune disorder in thymoma. Finally, we also found that SCAP (hsa_circ_0007291 parental gene) and AFF2 (hsa_circ_0001947 parental gene) were all significantly related with progression-free survival (PFS) of thymoma patients in a Kaplan-Meier plot (p-value <0.05).
CONCLUSIONS
The expression levels of hsa_circ_0001173, hsa_circ_0007291, hsa_circ_0003550, and hsa_circ_0001947 were significantly upregulated and positively correlated with immune imbalance in thymoma patients.
Topics: Humans; RNA, Circular; Survival Analysis; Thymoma
PubMed: 33704915
DOI: 10.1111/1759-7714.13873 -
Current Oncology (Toronto, Ont.) Dec 2022B3 type thymoma is defined as a well-differentiated thymic carcinoma and is similar to a thymic carcinoma. However, the differences between them are not well defined. In...
BACKGROUND
B3 type thymoma is defined as a well-differentiated thymic carcinoma and is similar to a thymic carcinoma. However, the differences between them are not well defined. In addition, the data to compare the efficacy and safety of platinum-based chemotherapy as first-line therapy between B3 thymoma and thymic carcinoma are lacking.
METHODS
The efficacy and safety of platinum-based chemotherapy as first-line therapy was retrospectively compared between a group of 36 patients with type B3 thymoma and a group of 127 patients with thymic carcinoma treated between January 2009 and March 2022 at the Zhejiang Cancer Hospital. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events were analyzed.
RESULTS
The ORRs for B3 thymoma and thymic carcinoma were 36.1% and 28.3%, respectively ( = 0.370). Among all patients, the difference in PFS between B3 thymoma and thymic carcinoma was not significant (11.3 vs. 10.1 months, = 0.118). The squamous carcinoma subgroup did not exhibit any differences in PFS compared to B3 thymoma (11.7 vs. 11.3 months, = 0.161). The result for the non-squamous carcinoma subgroup was similar (6.5 vs. 11.3 months, = 0.128). Furthermore, the OS values for B3 thymoma and thymic carcinoma were not significantly different (58.3 vs. 35.1 months, = 0.067). However, there were differences in OS between B3 thymoma and non-squamous carcinoma (58.3 vs. 30.6 months, = 0.031).
CONCLUSIONS
B3 thymoma and especially squamous carcinoma patients may be treated using a similar therapy scheme as that utilized for thymic carcinoma.
Topics: Humans; Thymoma; Platinum; Retrospective Studies; Thymus Neoplasms; Carcinoma, Squamous Cell
PubMed: 36547157
DOI: 10.3390/curroncol29120743 -
World Journal of Surgical Oncology Sep 2014Because of the rarity of thymoma, no randomized trials have prospectively detected the prognosis and optimal treatment for type B2 thymoma. The aim of this study is to...
BACKGROUND
Because of the rarity of thymoma, no randomized trials have prospectively detected the prognosis and optimal treatment for type B2 thymoma. The aim of this study is to investigate the treatment and prognosis for patients with type B2 thymoma.
METHODS
We retrospectively evaluated the outcome of 42 patients with type B2 thymoma who were treated between 1995 and 2010 in Zhejiang Cancer Hospital. Survival curves were plotted using the Kaplan-Meier method. The Cox proportional hazard model was used for multivariate analysis.
RESULTS
The current study included 42 patients. The 5-year disease-free survival and overall survival rates were 62.8% and 84.9%, respectively. There were significant differences in disease-free survival and overall survival among different Masaoka stages (both P<0.001). Univariate and multivariate analysis revealed that Masaoka stage was associated with disease-free survival and overall survival (P=0.00 and 0.001, respectively).
CONCLUSIONS
Our results indicate that Masaoka stage affects disease-free survival and overall survival of patients with type B2 thymoma.
Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prognosis; Radiotherapy, Adjuvant; Retrospective Studies; Survival Analysis; Thymectomy; Thymoma; Thymus Neoplasms; Treatment Outcome; Young Adult
PubMed: 25240293
DOI: 10.1186/1477-7819-12-291 -
Nature Communications Sep 2020Thymoma is the most common tumor of the anterior mediastinum. Routine imaging methods such as computed tomography or magnetic resonance imaging often lead to...
Thymoma is the most common tumor of the anterior mediastinum. Routine imaging methods such as computed tomography or magnetic resonance imaging often lead to misdiagnosis between thymoma and other thymic abnormalities. Therefore, urgently needed is to develop a new diagnostic strategy. Here we identify interleukin-8 (IL-8) as a biomarker for auxiliary diagnosis of thymoma. We find that IL-8 levels in naïve T cells are markedly elevated in patients with thymoma compared to those with other thymic tumors. IL-8 levels in naive T cells are significantly decreased after surgical resection in thymoma patients, and rise again when thymoma recurs. A receiver operating characteristic curve analysis shows that IL-8 evaluation performs well in thymoma identification, with high specificities and sensitivities. We also observe significant clinical relevance between IL-8 levels in naïve T cells and clinicopathological features. In conclusion, our study suggests that IL-8 is a biomarker for thymoma identification and recurrence surveillance.
Topics: Adult; Aged; Biomarkers, Tumor; Female; Humans; Interleukin-8; Male; Middle Aged; Neoplasm Recurrence, Local; Thymoma; Thymus Neoplasms; Young Adult
PubMed: 32985506
DOI: 10.1038/s41467-020-18697-x -
Thoracic Cancer Feb 2021Fibrous bands (FBs) are one of the histological features in tumors which can be confirmed by hematoxylin and eosin (H&E)-stained slides. FBs have been reported to...
BACKGROUND
Fibrous bands (FBs) are one of the histological features in tumors which can be confirmed by hematoxylin and eosin (H&E)-stained slides. FBs have been reported to correlate with malignancy in various tumors. This study aimed to investigate whether the presence of FBs is associated with malignancy in thymoma.
METHODS
A total of 123 consecutive patients with thymoma who underwent microscopically complete resections from January 2000 to December 2018 were enrolled into this study. H&E-stained slides of all thymoma patients were re-examined. Study patients were classified into two groups: with FBs (n = 36) and without FBs (n = 87). Clinicopathological characteristics, overall survival (OS), and recurrence-free survival (RFS) were compared between the two groups. Furthermore, multivariate analyses were performed to identify whether the presence of FBs was associated with higher Masaoka stage and poor prognosis in patients with thymoma.
RESULTS
The Masaoka stage was found to be higher and recurrence more likely in thymoma patients with FBs than in those without. RFS was significantly poorer in thymoma patients with FBs than in those without, although no significant difference was observed in OS between them. The presence of FBs was significantly associated with higher Masaoka stage in the multivariate analysis using logistic regression. Additionally, the presence of FBs was an independent prognostic factor for poor RFS in multivariate analysis using Cox's proportional hazards model.
CONCLUSIONS
The presence of FBs in patients with thymoma was associated with higher Masaoka stage, higher recurrence rate, and poorer RFS.
KEY POINTS
SIGNIFICANT FINDINGS OF THE STUDY: Fibrous bands (FBs) are bands of fibrosis dividing tumors into different-sized irregular islands. The presence of FBs is associated with higher Masaoka stage and poor recurrence-free survival in patients with thymoma.
WHAT THIS STUDY ADDS
The presence of fibrous bands might be associated with the malignant behavior of thymoma. Confirming the presence or absence of FBs may result in personalized medication for patients with thymoma.
Topics: Adult; Aged; Aged, 80 and over; Female; Fibrosis; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Thymoma; Young Adult
PubMed: 33236521
DOI: 10.1111/1759-7714.13755 -
Medical Science Monitor : International... Jul 2021BACKGROUND Thymoma is the most common tumor of the anterior mediastinum, and can be caused by infrequent malignancies arising from the epithelial cells of the thymus....
BACKGROUND Thymoma is the most common tumor of the anterior mediastinum, and can be caused by infrequent malignancies arising from the epithelial cells of the thymus. Unfortunately, blood-based diagnostic markers are not currently available. High-throughput sequencing technologies, such as RNA-seq with next-generation sequencing, have facilitated the detection and characterization of both coding and non-coding RNAs (ncRNAs), which play significant roles in genomic regulation, transcriptional and post-transcriptional regulation, and imprinting and epigenetic modification. The knowledge about fusion genes and ncRNAs in thymomas is scarce. MATERIAL AND METHODS For this study, we gathered large-scale RNA-seq data belonging to samples from 25 thymomas and 25 healthy thymus specimens and analyzed them to identify fusion genes, lncRNAs, and miRNAs. RESULTS We found 21 fusion genes, including KMT2A-MAML2, HADHB-REEP1, COQ3-CGA, MCM4-SNTB1, and IFT140-ACTN4, as the most frequent and significant in thymomas. We also detected 65 differentially-expressed lncRNAs in thymomas, including AFAP1-AS1, LINC00324, ADAMTS9-AS1, VLDLR-AS1, LINC00968, and NEAT1, that have been validated with the TCGA database. Moreover, we identified 1695 miRNAs from small RNA-seq data that were overexpressed in thymomas. Our network analysis of the lncRNA-mRNA-miRNA regulation axes identified a cluster of miRNAs upregulated in thymomas, that can trigger the expression of target protein-coding genes, and lead to the disruption of several biological pathways, including the PI3K-Akt signaling pathway, FoxO signaling pathway, and HIF-1 signaling pathway. CONCLUSIONS Our results show that overexpression of this miRNA cluster activates PI3K-Akt, FoxO, HIF-1, and Rap-1 signaling pathways, suggesting pathway inhibitors may be therapeutic candidates against thymoma.
Topics: Adult; Aged; Biomarkers, Tumor; Female; Humans; Male; Middle Aged; RNA, Long Noncoding; Thymoma; Thymus Neoplasms
PubMed: 34219124
DOI: 10.12659/MSM.929727 -
Thoracic Cancer Jan 2019Thymoma and thymic carcinoma are rare thymic epithelial tumors. We investigated the efficacy of first-line gemcitabine and cisplatin (GP) chemotherapy versus gemcitabine...
BACKGROUND
Thymoma and thymic carcinoma are rare thymic epithelial tumors. We investigated the efficacy of first-line gemcitabine and cisplatin (GP) chemotherapy versus gemcitabine and cisplatin chemotherapy combined with the anti-angiogenic drug endostar (GP + E) in advanced thymoma and thymic carcinoma.
METHODS
The records of 45 patients with invasive metastatic thymomas or thymic carcinomas treated with GP as first-line therapy between August 2008 and July 2017 at the Department of Respiratory Medicine, Peking University Cancer Hospital and Institute were retrospectively reviewed.
RESULTS
Eighteen patients (75%) in the GP + E group achieved a partial response and six (25%) had stable disease. In GP only group, nine (42.8%) patients achieved a partial response, 11 (52.4%) had stable disease, and one (4.8%) had progressive disease. The GP + E group had a significantly higher overall response rate (75% vs. 42.9%; P = 0.028), and median progression-free survival (PFS) and overall survival (OS) of 19 and 76 months, respectively. In the GP only group, median PFS and OS were 16 and 29 months, respectively. PFS and OS were not significantly different between the groups.
CONCLUSIONS
GP has moderate efficacy and could represent a suitable first-line therapy for thymic carcinoma and thymoma. Chemotherapy combined with endostar could improve the overall response rate, but did not prolong PFS or OS.
Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Deoxycytidine; Disease-Free Survival; Drug-Related Side Effects and Adverse Reactions; Endostatins; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Staging; Neoplasms, Glandular and Epithelial; Recombinant Proteins; Thymoma; Thymus Neoplasms; Uganda; Gemcitabine
PubMed: 30411854
DOI: 10.1111/1759-7714.12891