Mortality from extrathymic malignancy after thymic tumour resections: incidences and risk factors

Masatsugu Hamaji, Takashi Sozu, Ryunosuke Machida, Shun Ichi Watanabe, Kazuo Yoshida, Shinichi Toyooka, Masayuki Tanahashi, Kazuya Kondo, Hirotoshi Horio, Meinoshin Okumura, Hiroshi Date

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To identify risk factors associated with extrathymic malignancy-related mortality after thymic epithelial tumour resection. METHODS: The Japanese Association for Research on the Thymus database registered the records of 2835 patients collected from 32 Japanese institutions from 1991 to 2010. The cumulative incidence function of death due to extrathymic malignancies or recurrence was calculated, with other causes of death as competing risks. Relevant risk factors associated with extrathymic malignancy-related deaths in patients with thymoma were evaluated using the Fine and Gray model. RESULTS: In total, 2701 patients were eligible for the analysis (thymoma, 2374; thymic carcinoma, 273; thymic neuroendocrine tumour, 54). The median follow-up period was 4.6 years. The cumulative incidence function of death due to extrathymic malignancies at 10 years was 2.2% (3.2% due to recurrence) in patients with thymoma, 1.6% (38.6% due to recurrence) in patients with thymic carcinoma and 0% (36.6% due to recurrence) in patients with thymic neuroendocrine tumour. In the multivariable analysis, age (every 10 years) at thymectomy [hazard ratio (HR) 2.19, 95% confidence interval (CI) 1.53-3.14; P < 0.001], male gender (HR 2.62, 95% CI 1.19-5.77; P = 0.017) and previous malignancies (HR 3.09, 95% CI 1.18-8.11; P = 0.022) were significant factors for death due to extrathymic malignancies after thymectomy. CONCLUSIONS: Continued management and early detection of extrathymic malignancies may improve survival of patients with thymoma who are male, of advanced age, or have previous malignancies. Prospective studies are required to further investigate the management of extrathymic malignancies.

Original languageEnglish
Pages (from-to)729-736
Number of pages8
JournalInteractive cardiovascular and thoracic surgery
Volume29
Issue number5
DOIs
Publication statusPublished - Nov 1 2019

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Thymus Neoplasms
Thymoma
Mortality
Incidence
Neoplasms
Recurrence
Thymectomy
Neuroendocrine Tumors
Confidence Intervals
Thymus Gland
Cause of Death
Databases
Prospective Studies

Keywords

  • Extrathymic malignancy
  • Surgery
  • Thymic carcinoma
  • Thymoma

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Mortality from extrathymic malignancy after thymic tumour resections : incidences and risk factors. / Hamaji, Masatsugu; Sozu, Takashi; Machida, Ryunosuke; Watanabe, Shun Ichi; Yoshida, Kazuo; Toyooka, Shinichi; Tanahashi, Masayuki; Kondo, Kazuya; Horio, Hirotoshi; Okumura, Meinoshin; Date, Hiroshi.

In: Interactive cardiovascular and thoracic surgery, Vol. 29, No. 5, 01.11.2019, p. 729-736.

Research output: Contribution to journalArticle

Hamaji, M, Sozu, T, Machida, R, Watanabe, SI, Yoshida, K, Toyooka, S, Tanahashi, M, Kondo, K, Horio, H, Okumura, M & Date, H 2019, 'Mortality from extrathymic malignancy after thymic tumour resections: incidences and risk factors', Interactive cardiovascular and thoracic surgery, vol. 29, no. 5, pp. 729-736. https://doi.org/10.1093/icvts/ivz177
Hamaji, Masatsugu ; Sozu, Takashi ; Machida, Ryunosuke ; Watanabe, Shun Ichi ; Yoshida, Kazuo ; Toyooka, Shinichi ; Tanahashi, Masayuki ; Kondo, Kazuya ; Horio, Hirotoshi ; Okumura, Meinoshin ; Date, Hiroshi. / Mortality from extrathymic malignancy after thymic tumour resections : incidences and risk factors. In: Interactive cardiovascular and thoracic surgery. 2019 ; Vol. 29, No. 5. pp. 729-736.
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T1 - Mortality from extrathymic malignancy after thymic tumour resections

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AU - Hamaji, Masatsugu

AU - Sozu, Takashi

AU - Machida, Ryunosuke

AU - Watanabe, Shun Ichi

AU - Yoshida, Kazuo

AU - Toyooka, Shinichi

AU - Tanahashi, Masayuki

AU - Kondo, Kazuya

AU - Horio, Hirotoshi

AU - Okumura, Meinoshin

AU - Date, Hiroshi

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N2 - OBJECTIVES: To identify risk factors associated with extrathymic malignancy-related mortality after thymic epithelial tumour resection. METHODS: The Japanese Association for Research on the Thymus database registered the records of 2835 patients collected from 32 Japanese institutions from 1991 to 2010. The cumulative incidence function of death due to extrathymic malignancies or recurrence was calculated, with other causes of death as competing risks. Relevant risk factors associated with extrathymic malignancy-related deaths in patients with thymoma were evaluated using the Fine and Gray model. RESULTS: In total, 2701 patients were eligible for the analysis (thymoma, 2374; thymic carcinoma, 273; thymic neuroendocrine tumour, 54). The median follow-up period was 4.6 years. The cumulative incidence function of death due to extrathymic malignancies at 10 years was 2.2% (3.2% due to recurrence) in patients with thymoma, 1.6% (38.6% due to recurrence) in patients with thymic carcinoma and 0% (36.6% due to recurrence) in patients with thymic neuroendocrine tumour. In the multivariable analysis, age (every 10 years) at thymectomy [hazard ratio (HR) 2.19, 95% confidence interval (CI) 1.53-3.14; P < 0.001], male gender (HR 2.62, 95% CI 1.19-5.77; P = 0.017) and previous malignancies (HR 3.09, 95% CI 1.18-8.11; P = 0.022) were significant factors for death due to extrathymic malignancies after thymectomy. CONCLUSIONS: Continued management and early detection of extrathymic malignancies may improve survival of patients with thymoma who are male, of advanced age, or have previous malignancies. Prospective studies are required to further investigate the management of extrathymic malignancies.

AB - OBJECTIVES: To identify risk factors associated with extrathymic malignancy-related mortality after thymic epithelial tumour resection. METHODS: The Japanese Association for Research on the Thymus database registered the records of 2835 patients collected from 32 Japanese institutions from 1991 to 2010. The cumulative incidence function of death due to extrathymic malignancies or recurrence was calculated, with other causes of death as competing risks. Relevant risk factors associated with extrathymic malignancy-related deaths in patients with thymoma were evaluated using the Fine and Gray model. RESULTS: In total, 2701 patients were eligible for the analysis (thymoma, 2374; thymic carcinoma, 273; thymic neuroendocrine tumour, 54). The median follow-up period was 4.6 years. The cumulative incidence function of death due to extrathymic malignancies at 10 years was 2.2% (3.2% due to recurrence) in patients with thymoma, 1.6% (38.6% due to recurrence) in patients with thymic carcinoma and 0% (36.6% due to recurrence) in patients with thymic neuroendocrine tumour. In the multivariable analysis, age (every 10 years) at thymectomy [hazard ratio (HR) 2.19, 95% confidence interval (CI) 1.53-3.14; P < 0.001], male gender (HR 2.62, 95% CI 1.19-5.77; P = 0.017) and previous malignancies (HR 3.09, 95% CI 1.18-8.11; P = 0.022) were significant factors for death due to extrathymic malignancies after thymectomy. CONCLUSIONS: Continued management and early detection of extrathymic malignancies may improve survival of patients with thymoma who are male, of advanced age, or have previous malignancies. Prospective studies are required to further investigate the management of extrathymic malignancies.

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KW - Thymic carcinoma

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