Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2025
Mortality Risk and Cause of Death Associated With Removal of the Adult Thymus: Analysis of the U.S. Thymoma Population.
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Resio Benjamin J, Canavan Maureen, Caturegli Giorgio, Detterbeck Frank, Boffa Daniel J
Аннотация
INTRODUCTION: Recent studies have suggested a continued role of the adult thymus in the immune system and an increase in 5-year mortality and cancer incidence related to its removal. We sought to corroborate these findings in patients undergoing thymectomy for thymoma in the United States.
METHODS: The National Cancer Database (NCDB) and the Surveillance Epidemiology and End Results (SEER) database from 2004 to 2022 were used to identify patients who underwent a total or partial thymectomy for localized (SEER) or small (NCDB) thymoma. Five-year survival and cause of death were compared with (1) the demographically adjusted U.S. population and (2) propensity-matched patients who had undergone surgery for favorable-prognosis breast or thyroid neoplasms.
RESULTS: The 5-year survival of 1186 patients (SEER) and 1307 patients (NCDB) who underwent total thymectomy for localized or small thymoma was not significantly different from the demographic-adjusted U.S. population or propensity-matched patients who had undergone thyroid lobectomy for thyroid cancer or partial mastectomy for ductal carcinoma in situ (DCIS) in both NCDB and SEER (93% versus 93%; 93% and 92% versus 93% and 92%; 95% and 94% versus 95% and 94%). There was no significant difference in survival between partial and total thymectomy (p = 0.16 SEER; p = 0.78 NCDB). Death from secondary cancer was rare after thymectomy (4.2 deaths/1000 person-years) and was not significantly different from that in the patients with resected breast or thyroid cancer.
CONCLUSIONS: Thymectomy in adults with small or localized thymomas was not associated with increased 5-year mortality or cancer death. Longer-term outcomes and specific immunologic end points deserve further study.
METHODS: The National Cancer Database (NCDB) and the Surveillance Epidemiology and End Results (SEER) database from 2004 to 2022 were used to identify patients who underwent a total or partial thymectomy for localized (SEER) or small (NCDB) thymoma. Five-year survival and cause of death were compared with (1) the demographically adjusted U.S. population and (2) propensity-matched patients who had undergone surgery for favorable-prognosis breast or thyroid neoplasms.
RESULTS: The 5-year survival of 1186 patients (SEER) and 1307 patients (NCDB) who underwent total thymectomy for localized or small thymoma was not significantly different from the demographic-adjusted U.S. population or propensity-matched patients who had undergone thyroid lobectomy for thyroid cancer or partial mastectomy for ductal carcinoma in situ (DCIS) in both NCDB and SEER (93% versus 93%; 93% and 92% versus 93% and 92%; 95% and 94% versus 95% and 94%). There was no significant difference in survival between partial and total thymectomy (p = 0.16 SEER; p = 0.78 NCDB). Death from secondary cancer was rare after thymectomy (4.2 deaths/1000 person-years) and was not significantly different from that in the patients with resected breast or thyroid cancer.
CONCLUSIONS: Thymectomy in adults with small or localized thymomas was not associated with increased 5-year mortality or cancer death. Longer-term outcomes and specific immunologic end points deserve further study.