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Thymic carcinoma patients with myasthenia gravis exhibit better prognoses

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Abstract

Background

Thymic carcinoma is an aggressive mediastinal neoplasm with a poor prognosis, but the factors that contribute to its prognosis are not completely understood. Myasthenia gravis (MG) can coexist with thymic carcinoma with low incidence, but the effect MG has on thymic carcinoma prognosis is unknown. Here, we investigated the prognostic factors of thymic carcinoma and the influence of MG on patients with this disease.

Methods

Between January 1996 and December 2012, 49 patients were diagnosed with thymic carcinoma and surgically treated at our institution. Clinical data and survival information were recorded and systematically reviewed. Kaplan–Meier survival curves were generated, and independent prognostic factors were identified by Cox’s proportional hazard model.

Results

Complete resection was achieved in 30 patients (61.2 %), and incomplete resection was performed on the other 19 patients (38.8 %). Six of the 49 patients with thymic carcinoma also presented with MG (12.2 %). Interestingly, these 6 patients exhibited much better prognoses when compared to the other 43 patients. Patients with MG also had significantly smaller tumors (P = 0.045), earlier Masaoka stage (P = 0.048), and higher complete resection rates (P = 0.042). However, multivariate analysis demonstrated that complete resection was the only independent predictor for overall survival (OS) (P < 0.001).

Conclusions

The OS of patients with thymic carcinoma depends on complete resection, but patients with MG also demonstrate improved prognoses. MG patients have higher rates of complete surgical resection, which may account for their better prognoses. Patients with MG have unique features that may aid in the clinical management of these patients.

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References

  1. Müller-Hermelink H, Engel P, Harris N et al (2004) Tumours of the thymus. In: Travis WD, Brambilla E, Müller-Helmelink HK, Harris CC (eds) Pathology and genetics of tumours of the lung, pleura, thymus and heart. WHO classification of tumors series. IARC Press, Lyon, France, pp 145–151

  2. Filosso PL, Guerrera F, Rendina AE et al (2014) Outcome of surgically resected thymic carcinoma: a multicenter experience. Lung Cancer 83(2):205–210. doi:10.1016/j.lungcan.2013.11.015

    Article  PubMed  Google Scholar 

  3. Chalabreysse L, Etienne-Mastroianni B, Adeleine P et al (2004) Thymic carcinoma: a clinicopathological and immunohistological study of 19 cases. Histopathology (Oxf) 44(4):367–374. doi:10.1111/j.1365-2559.2004.01796.x

    Article  CAS  Google Scholar 

  4. Blumberg D, Burt ME, Bains et al (1998) Thymic carcinoma: current staging does not predict prognosis. J Thorac Cardiovasc Surg 115(2):303–308 (discussion 308–309)

    Article  CAS  PubMed  Google Scholar 

  5. Kondo K, Monden Y (2003) Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan. Ann Thorac Surg 76(3):878–884 (discussion 884–875)

    Article  PubMed  Google Scholar 

  6. Detterbeck F, Youssef S, Ruffini E et al (2011) A review of prognostic factors in thymic malignancies. J Thorac Oncol 6(7 suppl 3):S1698–S1704. doi:10.1097/JTO.0b013e31821e7b12

    Article  PubMed  Google Scholar 

  7. Modh A, Rimner A, Allen PK et al (2014) Treatment modalities and outcomes in patients with advanced invasive thymoma or thymic carcinoma: a retrospective multicenter study. Am J Clin Oncol. doi:10.1097/COC.0000000000000024

    PubMed  Google Scholar 

  8. Hosaka Y, Tsuchida M, Toyabe S et al (2010) Masaoka stage and histologic grade predict prognosis in patients with thymic carcinoma. Ann Thorac Surg 89(3):912–917. doi:10.1016/j.athoracsur.2009.11.057

    Article  PubMed  Google Scholar 

  9. Weksler B, Dhupar R, Parikh V et al (2013) Thymic carcinoma: a multivariate analysis of factors predictive of survival in 290 patients. Ann Thorac Surg 95(1):299–303. doi:10.1016/j.athoracsur.2012.09.006

    Article  PubMed  Google Scholar 

  10. Weissferdt A, Moran CA (2012) Thymic carcinoma, part 1: a clinicopathologic and immunohistochemical study of 65 cases. Am J Clin Pathol 138(1):103–114. doi:10.1309/AJCP88FZTWANLRCB

    Article  PubMed  Google Scholar 

  11. Spillane J, Higham E, Kullmann DM (2012) Myasthenia gravis. BMJ 345:e8497. doi:10.1136/bmj.e8497

    Article  CAS  PubMed  Google Scholar 

  12. Angelini C (2011) Diagnosis and management of autoimmune myasthenia gravis. Clin Drug Invest 31(1):1–14. doi:10.2165/11584740-000000000-00000

    Article  CAS  Google Scholar 

  13. Drachman DB (1994) Myasthenia gravis. N Engl J Med 330(25):1797–1810. doi:10.1056/NEJM199406233302507

    Article  CAS  PubMed  Google Scholar 

  14. Skeie GO, Romi F (2008) Paraneoplastic myasthenia gravis: immunological and clinical aspects. Eur J Neurol 15(10):1029–1033. doi:10.1111/j.1468-1331.2008.02242.x

    Article  CAS  PubMed  Google Scholar 

  15. Venuta F, Anile M, Diso D et al (2010) Thymoma and thymic carcinoma. Eur J Cardiothorac Surg 37(1):13–25. doi:10.1016/j.ejcts.2009.05.038

    Article  PubMed  Google Scholar 

  16. Zhao Y, Zhao H, Hu D et al (2013) Surgical treatment and prognosis of thymic squamous cell carcinoma: a retrospective analysis of 105 cases. Ann Thorac Surg 96(3):1019–1024. doi:10.1016/j.athoracsur.2013.04.078

    Article  PubMed  Google Scholar 

  17. Liu HC, Hsu WH, Chen YJ et al (2002) Primary thymic carcinoma. Ann Thorac Surg 73(4):1076–1081

    Article  PubMed  Google Scholar 

  18. Berrih-Aknin S, Frenkian-Cuvelier M, Eymard B (2014) Diagnostic and clinical classification of autoimmune myasthenia gravis. J Autoimmun 48-49:143–148

    Article  CAS  PubMed  Google Scholar 

  19. Suster S, Rosai J (1991) Thymic carcinoma. A clinicopathologic study of 60 cases. Cancer (Phila) 67(4):1025–1032

    Article  CAS  Google Scholar 

  20. Filosso PL, Ruffini E, Lausi PO et al (2014) Historical perspectives: the evolution of the thymic epithelial tumors staging system. Lung Cancer 83(2):126–132. doi:10.1016/j.lungcan.2013.09.013

    Article  PubMed  Google Scholar 

  21. Koga K, Matsuno Y, Noguchi M et al (1994) A review of 79 thymomas: modification of staging system and reappraisal of conventional division into invasive and non-invasive thymoma. Pathol Int 44(5):359–367

    Article  CAS  PubMed  Google Scholar 

  22. Okereke IC, Kesler KA, Freeman RK et al (2012) Thymic carcinoma: outcomes after surgical resection. Ann Thorac Surg 93(5):1668–1672. doi:10.1016/j.athoracsur.2012.01.014 (discussion 1672–1673)

    Article  PubMed  Google Scholar 

  23. Ogawa K, Toita T, Uno T et al (2002) Treatment and prognosis of thymic carcinoma: a retrospective analysis of 40 cases. Cancer (Phila) 94(12):3115–3119. doi:10.1002/cncr.10588

    Article  Google Scholar 

  24. Huang J, Detterbeck FC, Wang Z et al (2011) Standard outcome measures for thymic malignancies. J Thorac Oncol 6(7 suppl 3):S1691–S1697. doi:10.1097/JTO.0b013e3182254ac1

    Article  PubMed  Google Scholar 

  25. Yano M, Sasaki H, Yokoyama T et al (2008) Thymic carcinoma: 30 cases at a single institution. J Thorac Oncol 3(3):265–269. doi:10.1097/JTO.0b013e3181653c71

    Article  PubMed  Google Scholar 

  26. Park IK, Kim YT, Jeon JH et al (2013) Importance of lymph node dissection in thymic carcinoma. Ann Thorac Surg 96(3):1025–1032. doi:10.1016/j.athoracsur.2013.04.057 (Discussion 1032)

    Article  PubMed  Google Scholar 

  27. Masaoka A, Monden Y, Nakahara K et al (1981) Follow-up study of thymomas with special reference to their clinical stages. Cancer (Phila) 48(11):2485–2492

    Article  CAS  Google Scholar 

  28. Tsuchiya R, Koga K, Matsuno Y et al (1994) Thymic carcinoma: proposal for pathological TNM and staging. Pathol Int 44(7):505–512

    Article  CAS  PubMed  Google Scholar 

  29. Berardi R, De Lisa M, Pagliaretta S et al (2014) Thymic neoplasms: an update on the use of chemotherapy and new targeted therapies. A literature review. Cancer Treat Rev 40(4):495–506. doi:10.1016/j.ctrv.2013.11.003

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors were responsible for the experimental design, execution of experiments, outcome parameters and analysis of data. No funding was obtained to support this study.

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Authors and Affiliations

  1. Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang, 110001, Liaoning Province, China

    Wenya Li, Qigang Zhang, Lei Sun, Peiwen Li, Wenke Liu & Lin Zhang

  2. Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, 110001, Liaoning Province, China

    Zhifeng Miao

  3. Department of Rheumatology and Immunology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, Liaoning Province, China

    Xudong Liu

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  1. Wenya Li
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  2. Zhifeng Miao
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  3. Xudong Liu
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  4. Qigang Zhang
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  5. Lei Sun
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  6. Peiwen Li
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  7. Wenke Liu
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  8. Lin Zhang
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Correspondence to Lin Zhang.

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Li, W., Miao, Z., Liu, X. et al. Thymic carcinoma patients with myasthenia gravis exhibit better prognoses. Int J Clin Oncol 21, 75–80 (2016). https://doi.org/10.1007/s10147-015-0862-z

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  • DOI: https://doi.org/10.1007/s10147-015-0862-z

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