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Thymoma and Thymic Carcinoma: Therapy and Outcomes

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 10722

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Special Issue Editors

Prof. Dr. Enrico Ruffini

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Guest Editor

Thoracic Surgery Unit, University of Torino, 10126 Turin, Italy
Interests: thoracic surgery; thoracic oncology; VATS; RATS

Prof. Dr. Pier Luigi Filosso

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Guest Editor

Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
Interests: thoracic surgery; thoracic oncology; VATS; RATS
Special Issues, Collections and Topics in MDPI journals

Dr. Paraskevas Lyberis

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Guest Editor

Thoracic Surgery Unit, University of Torino, Turin, Italy
Interests: thoracic surgery; thoracic oncology; VATS; RATS

Special Issue Information

Dear Colleagues,

In view of your expertise, we are pleased to invite you to submit an article for the Special Issue “Thymoma and Thymic Carcinoma: Therapy and Outcomes” for the journal Cancers. This Special Issue aims to review and analyse current knowledge and clinical practice applied to thymic malignancies, and their short- and long-term outcomes.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: surgery for thymic malignancies, radiotherapy for thymic malignancies, oncological treatments for thymic malignancies, thymic malignancies and miastenia gravis, follow-up in thymic malignancies, and outcomes in thymic malignancies.

We look forward to receiving your contribution.

Prof. Dr. Enrico Ruffini
Prof. Dr. Pier Luigi Filosso
Dr. Paraskevas Lyberis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

thymoma
thymic carcinoma
thymectomy
thoracic oncology
thoracic pathology
thymic malignancy

Published Papers (5 papers)

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Research

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10 pages, 789 KiB

Open AccessArticle

Subtotal Pleurectomy with Intrathoracic Chemo Hyperthermia (HITHOC) for IVa Thymomas: De Novo Versus Recurrent Pleural Disease

by Benjamin Chappuy, Gabrielle Drevet, Hugo Clermidy, Pascal Rosamel, Mickael Duruisseaux, Sebastien Couraud, Renaud Grima, Valentin Soldea, Lara Chalabreysse, François Tronc, Nicolas Girard and Jean-Michel Maury

Cancers 2022, 14(20), 5035; https://doi.org/10.3390/cancers14205035 - 14 Oct 2022

Cited by 2 | Viewed by 1359

Abstract

Introduction: Stage IVa thymoma is a rare disease without a standard of care. Subtotal pleurectomy and HITHOC introduced in highly selected patients may provide interesting oncologic results. The purpose of this study was to distinguish de novo stage IVa tumors (DNT) from distant relapse (DR) with respect to post-operative and long-term outcomes to provide the procedure efficacy. Methods: From July 1997–December 2021, 40 patients with IVa pleural involvement were retrospectively analyzed. The surgical procedure was subtotal pleurectomy and HITHOC (cisplatin 50 mg/m², mitomycin 25 mg/m², 42 °C, 90 min). The post-operative outcome, disease-free interval (DFI) and overall survival (OS) were analyzed. Results: Mean age was 52 ± 12 years. B2 and B3 thymomas were preponderant (27; 67.5%). The median number of pleural nodes were nine (4–81) vs. five (1–36); p = 0.004 * in DNT and DR, respectively. Hospital mortality rate was 2.5%. There were four specific HITHOC complications (10%). DFI were 49 and 85 months (p = 0.02 *), OS were 94 and 118 months (NS), in DNT and DR, respectively. Conclusions: Subtotal pleurectomy with HITHOC in IVa offers satisfying results in highly selected patients, for both DNT and DR. Due to the disease rarity, multicentric studies are needed to define HITHOC as a standard of care. Full article

(This article belongs to the Special Issue Thymoma and Thymic Carcinoma: Therapy and Outcomes)

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12 pages, 1987 KiB

Open AccessArticle

A Single Center Analysis of Thymic Neuroendocrine Tumors

by Yirui Zhai, Qiang Zeng, Nan Bi, Zongmei Zhou, Zefen Xiao, Zhouguang Hui, Dongfu Chen, Luhua Wang, Jianyang Wang, Wenyang Liu, Lei Deng, Jima Lv, Wenqing Wang, Yang Luo, Junling Li, Xin Wang, Tao Zhang, Yushun Gao and Qinfu Feng

Cancers 2022, 14(19), 4944; https://doi.org/10.3390/cancers14194944 - 9 Oct 2022

Cited by 1 | Viewed by 1650

Abstract

Purpose: Thymic neuroendocrine tumors (TNETs) are a collection of slow-progressing neoplasms located in the anterior mediastinum. Relatively few previously published studies have focused on thymic carcinomas. This study investigated the basic clinical characteristics, treatment, and prognosis of TNETs. Methods: Patients were enrolled in the study from January 2003 to December 2017 who had been diagnosed with TNETs through pathological screening and treated at our institution. Demographic data from each patient, the Masaoka stage, histology and size of the tumor, tumor invasion characteristics, and therapeutic strategies were gathered. The Kaplan–Meier method was used to assess patient survival. In addition, the log-rank test was used to carry out univariate analyses. Results: Twenty-six patients were eligible for inclusion in the study. The median age of the patients was 46.5 (25–69) years. The tumor median maximum diameter was 7.9 cm (from 3 to 19 cm). Twenty-four patients were treated surgically. Nineteen patients completed radiation therapy, and sixteen patients underwent chemotherapy. A median follow-up time of 54.95 months was observed. The survival rate for three years was 75.0% and 70.6% for five years. The corresponding progression-free survival rates for three and five years were 55.7% and 37.7%, respectively. The local, regional recurrence-free survival (LRFS) rates were 87.2% and 81.7%, and the distant metastasis-free survival (DMFS) rates were 55.7% and 37.7%, at three and five years, respectively. Local recurrence (six patients) and bone metastasis (six patients) were observed as the most frequent failures. Conclusion: TNET was observed to be an aggressive but rare malignant lesion. While the predominant treatment was complete resection, chemotherapy and radiotherapy were also required due to the high recurrence rate. Full article

(This article belongs to the Special Issue Thymoma and Thymic Carcinoma: Therapy and Outcomes)

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21 pages, 3141 KiB

Open AccessArticle

The Prognostic Value of Postoperative Radiotherapy for Thymoma and Thymic Carcinoma: A Propensity-Matched Study Based on SEER Database

by Chi Zhang, Qin Wang, Liwen Hu, Zhuangzhuang Cong, Yong Qiang, Fei Xu, Zheng Zhang, Chao Luo, Bingmei Qiu, Xiaokun Li and Yi Shen

Cancers 2022, 14(19), 4938; https://doi.org/10.3390/cancers14194938 - 8 Oct 2022

Cited by 4 | Viewed by 1909

Abstract

(1) Objectives: The effect of postoperative radiotherapy (PORT) for thymoma and thymic carcinoma remains controversial. This study aimed to investigate the prognostic value of PORT for thymoma and thymic carcinoma in a population-based registry. (2) Methods: This retrospective study used the Surveillance, Epidemiology, and End Results (SEER) database to identify patients diagnosed with thymoma and thymic carcinoma between 2010 and 2019. Propensity score matching was performed to adjust statistical influences between the PORT and non-PORT groups. (3) Results: A total of 2558 patients with thymoma (n = 2138) or thymic carcinoma (n = 420) were included. In the multivariate analysis, PORT was an independent prognostic factor for OS (overall survival; p < 0.001) and CSS (cancer-specific survival; p = 0.001) in thymoma and an independent prognostic factor for OS in thymic carcinoma (p = 0.018). Subgroup analyses revealed that PORT was beneficial to OS and CSS in patients with Masaoka-Koga stage IIB-IV thymoma (OS: IIB, p < 0.001; III-IV, p = 0.005; CSS: IIB, p = 0.015; III-IV, p = 0.002) and stage IIB thymic carcinoma (OS: p = 0.012; CSS: p = 0.029). (4) Conclusion: This propensity-matched analysis identified the prognostic value of PORT in thymoma and thymic carcinoma based on the SEER database. For patients with stage IIB-IV thymoma and stage IIB thymic carcinoma, PORT was associated with improved OS and CSS. A more positive attitude towards the use of PORT for nonlocalized thymoma and thymic carcinoma may be appropriate. Full article

(This article belongs to the Special Issue Thymoma and Thymic Carcinoma: Therapy and Outcomes)

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Review

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14 pages, 1121 KiB

Open AccessReview

Thymic Epithelial Tumor and Immune System: The Role of Immunotherapy

by Matteo Perrino, Nadia Cordua, Fabio De Vincenzo, Federica Borea, Marta Aliprandi, Luigi Giovanni Cecchi, Roberta Fazio, Marco Airoldi, Armando Santoro and Paolo Andrea Zucali

Cancers 2023, 15(23), 5574; https://doi.org/10.3390/cancers15235574 - 25 Nov 2023

Viewed by 1283

Abstract

Thymic epithelial tumors (TETs) comprise a rare group of thoracic cancers, classified as thymomas and thymic carcinomas (TC). To date, chemotherapy is still the standard treatment for advanced disease. Unfortunately, few therapeutic options are available for relapsed/refractory tumors. Unlike other solid cancers, the development of targeted biologic and/or immunologic therapies in TETs remains in its nascent stages. Moreover, since the thymus plays a key role in the development of immune tolerance, thymic tumors have a unique biology, which can confer susceptibility to autoimmune diseases and ultimately influence the risk–benefit balance of immunotherapy, especially for patients with thymoma. Indeed, early results from single-arm studies have shown interesting clinical activity, albeit at a cost of a higher incidence of immune-related side effects. The lack of knowledge of the immune mechanisms associated with TETs and the absence of biomarkers predictive of response or toxicity to immunotherapy risk limiting the evolution of immunotherapeutic strategies for managing these rare tumors. The aim of this review is to summarize the existing literature about the thymus’s immune biology and its association with autoimmune paraneoplastic diseases, as well as the results of the available studies with immune checkpoint inhibitors and cancer vaccines. Full article

(This article belongs to the Special Issue Thymoma and Thymic Carcinoma: Therapy and Outcomes)

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15 pages, 5185 KiB

Open AccessReview

Thymoma and Thymic Carcinoma: Surgical Resection and Multidisciplinary Treatment

by Yue Zhang, Dong Lin, Beatrice Aramini, Fu Yang, Xi Chen, Xing Wang, Liang Wu, Wei Huang and Jiang Fan

Cancers 2023, 15(7), 1953; https://doi.org/10.3390/cancers15071953 - 24 Mar 2023

Cited by 8 | Viewed by 3827

Abstract

Thymoma and thymic carcinoma are the most common tumors of the anterior mediastinum and a relatively rare type of thoracic cancer. The prerequisite for surgery is clinical staging and operative evaluation, both of which are based on medical imaging. The best strategy for treating a thymic epithelial tumor is surgical resection of the organ and surrounding tissue. Thymectomy modalities vary, including open surgery and minimally invasive surgery, and surgeons have used various innovations to better meet the needs of the procedure; therefore, it is critical to select the appropriate procedure based on the patient’s characteristics. Evaluation of resectability is the first step of surgical resection for thymic tumors without distant metastasis. The decision regarding unresectability should be made carefully. During subsequent chemotherapy or chemoradiotherapy, reevaluation of whether an area is resectable or not remains essential. Despite numerous technological advances in the surgical treatment of thymic tumors, several contentious issues remain, including the selection of surgical approaches for difficult cases, the selection of video-assisted thoracoscopic approaches, the evaluation of resectability, minimally invasive surgery for locally advanced thymic tumors, lymphadenectomy in thymic tumors, neoadjuvant therapy for thymic tumors, debulking surgery, and salvage surgery. In solving these problems, the surgeon’s judgment, surgical experience, and surgical skills are especially important. Full article

(This article belongs to the Special Issue Thymoma and Thymic Carcinoma: Therapy and Outcomes)

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