WCLC 2025 - Posters & ePosters-P3.14.19 The Role of Tumors Size in Different Thymic Tumors Histology: Results Form the ESTS Thymic Database

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This study, based on the ESTS Thymic database, assessed the prognostic significance of tumor size in various thymic epithelial tumors (TETs), including thymoma, thymic carcinoma, and neuroendocrine tumors (NET), involving 2556 patients treated surgically between 2000 and 2022. Thymoma comprised 87.3% of cases, thymic carcinoma 10.6%, and NET 2.1%. Tumor size was analyzed primarily using 5 cm and 3 cm cut-offs, correlating with survival outcomes: overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS).<br /><br />Key findings demonstrated that tumor size is a significant independent prognostic factor across TET histologies. Patients with tumors ≤5 cm exhibited notably better outcomes than those with tumors >5 cm. For the entire TET group, 5- and 10-year DFS rates were 82.4% and 76% for tumors ≤5 cm compared to 73.8% and 60% for larger tumors (p<0.001). Similarly, OS and CSS were superior in smaller tumors: 5- and 10-year OS at 91.2% and 82.8% versus 86.1% and 73%, and CSS at 96.9% and 92.3% versus 94.1% and 88.8% (all p≤0.012). Subgroup analyses confirmed the size impact in both thymoma and thymic carcinoma/NET groups. Importantly, these size-related prognostic differences were consistent independently of histological subtype.<br /><br />The analysis supports incorporating tumor size, especially the 5 cm threshold, as a reliable prognostic indicator in TETs, complementing histology and staging. This validates recent inclusion of tumor size in the 9th edition TNM classification for thymic tumors. The study highlights tumor size as a practical, significant factor for stratifying risk and guiding clinical management across thymic tumor histologies.<br /><br />In summary, tumor size is a key prognostic marker in thymic tumors, influencing survival outcomes regardless of histological type, reinforcing its role in staging systems and therapeutic decision-making.

Asset Subtitle

Marco Chiappetta

Meta Tag

Speaker Marco Chiappetta

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

thymic epithelial tumors

tumor size

prognostic factor

thymoma

thymic carcinoma

neuroendocrine tumors

overall survival

disease-free survival

cancer-specific survival

TNM classification