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Hum Pathol. 2018 Mar;73:7-15. doi: 10.1016/j.humpath.2017.08.018. Epub 2017 Aug 26.

Thymoma: a clinicopathological correlation of 1470 cases.

Author information

1
Department of Pathology at MD Anderson Cancer Center, Houston, TX, USA.
2
The Johns Hopkins Hospital, Baltimore, MD, USA.
3
Asan Medical Center, Ulsan University School of Medicine, Seoul, Republic of Korea.
4
Methodist Hospital, Houston, TX, USA.
5
National University Hospital, Singapore.
6
Heart of England NHS Foundation Trust, Birmingham, United Kingdom.
7
Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College Hospital, Peking, China.
8
Serv Anatomia Patologica, Hospital Pulido Valente, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
9
Lund University, Laboratory Medicine, Department of Clinical Sciences Lund, Pathology, Lund, Sweden.
10
PathWest Laboratory Medicine Western Australia; University of Western Australia, School of Pathology and Laboratory Medicine, Nedlands, Western Australia, Australia; University of Notre Dame, Fremantle, Western Australia, Australia.
11
The Ohio State University, Columbus, OH, USA.
12
Department of Laboratory Medicine, Pathology Orebro University Hospital, Orebro, Sweden.
13
A.C. Camargo Cancer Center, Sao Paulo, Brazil.
14
Cukurova University Faculty of Medicine, Adana, Turkey.
15
Mexican Oncology Hospital, Mexico City, Mexico.
16
Moffitt Cancer Center, Tampa, Florida, USA.
17
Departments of Thoracic Surgery at M D Anderson Cancer Center, Houston, TX, USA.
18
Temple University School of Medicine, Philadelphia, PA, USA.
19
Department of Pathology at MD Anderson Cancer Center, Houston, TX, USA. Electronic address: cesarmoran@mdanderson.org.

Abstract

We present 1470 surgical resections for thymoma identified in the pathology files of 14 institutions from 11 countries with the purpose of determining and correlating a simplified histological classification of thymoma and pathological staging with clinical outcome. The study population was composed of 720 men and 750 women between the ages of 12 and 86 years (average, 54.8 years). Clinically, 137 patients (17%) had a history of myasthenia gravis, 31 patients (3.8%) of other autoimmune disease, and 55 (6.8%) patients of another neoplastic process. Surgical resection was performed in all patients. Histologically, 1284 (87.13%) cases were thymomas (World Health Organization types A, B1, and B2, and mixed histologies), and 186 (12.7%) were atypical thymomas (World Health Organization type B3). Of the entire group, 630 (42.9%) were encapsulated thymomas, and 840 (57.9%) were invasive thymomas in different stages. Follow-up information was obtained in 1339 (91%) patients, who subsequently were analyzed by univariate and multivariate statistical analysis. Follow-up ranging from 1 to 384 months was obtained (mean, 69.2 months) showing tumor recurrence in 136 patients (10.1%), whereas 227 died: 64 (28.2%) due to tumor and 163 (71.8%) due to other causes. Statistical analysis shows that separation of these tumors into thymoma and atypical thymoma is statistically significant (P = .001), whereas tumor staging into categories of encapsulated, minimally invasive, and invasion into adjacent organs offers a meaningful clinical assessment with a P = .038. Our findings suggest that our simplified histological schema and pathological staging system are excellent predictors of clinical outcome.

KEYWORDS:

Classification; Mediastinum; Staging; Thymoma; Thymus

PMID:
28851660
DOI:
10.1016/j.humpath.2017.08.018
[Indexed for MEDLINE]

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