Journal of pediatric surgery · 2026
Thymic epithelial tumors in pediatric, adolescent, and young adult patients: A national cohort analysis of clinical characteristics, treatment patterns, and survival outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nofi Colleen P, Jou Katerina, Theodorou Christina M, Edelman Morris C, Rich Barrie S, Glick Richard D
Аннотация
BACKGROUND: Thymic epithelial tumors (TETs), including thymoma and thymic carcinoma, are rare in young patients, with limited data on clinical characteristics and outcomes. We aimed to evaluate demographics, treatment strategies, and outcomes in pediatric/adolescent and young adult (YA) patients with TETs.
METHODS: The National Cancer Database was queried for patients aged 0-39 years with thymoma or thymic carcinoma from 2004 to 2019. Descriptive statistics were performed, and overall survival was analyzed using Cox regressions. Kaplan-Meier analysis was stratified by age (pediatric/adolescent: 0-21 years; YA: 22-39 years) and tumor type.
RESULTS: 1069 patients were identified, of which 193 (18 %) had thymic carcinoma and 876 (82 %) had thymoma. Pediatric/adolescent patients accounted for 98 cases (9 %). Most patients underwent surgical resection (77 %), primarily via open approach (72 %); fewer received radiation (43 %) or chemotherapy (45 %). Five-year survival was 36 % for thymic carcinoma and 87 % for thymoma. On multivariable analysis, thymic carcinoma (HR 2.9, p < 0.001), advanced Masaoka stage (III: HR 2.0, p = 0.001; IV: HR 3.0, p < 0.001), positive margins (HR 1.6, p = 0.015), and chemotherapy (HR 1.5, p = 0.020) were associated with worse survival, while surgery (HR 0.2, p < 0.001) and older age (HR 0.97, p = 0.002) were associated with improved survival. Thymic carcinoma outcomes were significantly worse for pediatric/adolescent patients compared to YAs (p = 0.03) - a difference not observed in thymoma (p = 0.17).
CONCLUSION: Thymic carcinoma and advanced disease predict poor survival, while complete resection is associated with improved outcomes. Notably, younger patients with thymic carcinoma have significantly worse survival, highlighting the need for age- and histology-specific treatment strategies.
METHODS: The National Cancer Database was queried for patients aged 0-39 years with thymoma or thymic carcinoma from 2004 to 2019. Descriptive statistics were performed, and overall survival was analyzed using Cox regressions. Kaplan-Meier analysis was stratified by age (pediatric/adolescent: 0-21 years; YA: 22-39 years) and tumor type.
RESULTS: 1069 patients were identified, of which 193 (18 %) had thymic carcinoma and 876 (82 %) had thymoma. Pediatric/adolescent patients accounted for 98 cases (9 %). Most patients underwent surgical resection (77 %), primarily via open approach (72 %); fewer received radiation (43 %) or chemotherapy (45 %). Five-year survival was 36 % for thymic carcinoma and 87 % for thymoma. On multivariable analysis, thymic carcinoma (HR 2.9, p < 0.001), advanced Masaoka stage (III: HR 2.0, p = 0.001; IV: HR 3.0, p < 0.001), positive margins (HR 1.6, p = 0.015), and chemotherapy (HR 1.5, p = 0.020) were associated with worse survival, while surgery (HR 0.2, p < 0.001) and older age (HR 0.97, p = 0.002) were associated with improved survival. Thymic carcinoma outcomes were significantly worse for pediatric/adolescent patients compared to YAs (p = 0.03) - a difference not observed in thymoma (p = 0.17).
CONCLUSION: Thymic carcinoma and advanced disease predict poor survival, while complete resection is associated with improved outcomes. Notably, younger patients with thymic carcinoma have significantly worse survival, highlighting the need for age- and histology-specific treatment strategies.