AB033. Thymic cancer in France: a comprehensive analysis of incidence based on French National Healthcare Data—a retrospective observational study
Original Research

AB033. Thymic cancer in France: a comprehensive analysis of incidence based on French National Healthcare Data—a retrospective observational study

Álvaro López-Gutiérrez1, Alexandre Lolivier2,3, Jose Carlos Benitez4, Jordi Remón1, Adrien Rousseau2, David Planchard1, Fabrice Barlesi1, Pernelle Lavaud1, Anas Gazzah5, Claudia Parisi1, Pamela Abdayem1, Daniela Miliziano1, Lodovica Zullo1, Martina Gasparro1, Diego Diaz-Jimenez1, Nicolas Girard6, Vincent Thomas de Montpréville7, Olaf Mercier8, Stephanie Foulon2,3, Benjamin Besse1

1Cancer Medicine Department, Gustave Roussy, Villejuif, France; 2Oncostat U1018, Inserm, suped Ligue Contre le Cancer, Paris-Saclay University, Villejuif, France; 3Biostatistics and Epidemiology Department, Gustave Roussy, Paris-Saclay University, Villejuif, France; 4Department of Medical Oncology, University Hospital Virgen de la Victoria, Málaga, Spain; 5Department of Drug Development, Gustave Roussy, Paris-Saclay University, Villejuif, France; 6Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France; 7Department of Pathology, Marie Lannelongue Hospital, Le Plessis Robinson, France; 8Department of Surgery, Marie Lannelongue Hospital, Le Plessis Robinson, France

Correspondence to: Álvaro López Gutiérrez, MD. Cancer Medicine Department, Institut Gustave Roussy, 114 Rue Edouard Vaillant, Villejuif, Île-de-France, 94800, France. Email: alvaro.lopez-gutierrez@gustaveroussy.fr.

Background: Thymic epithelial tumors (TETs) are rare malignancies with an estimated incidence of 0.18 cases per 100,000 person-years in the European Union. Comprehensive national data remain limited. This study aimed to evaluate the epidemiology, clinical characteristics, and associated conditions of TETs in France.

Methods: A retrospective cohort was extracted from the French National Health Data System (SNDS), which covers over 99% of the population and integrates health insurance and hospital data. Patients hospitalized with a primary diagnosis of malignant thymic neoplasm (ICD-10 code C37) between 2015 and 2019 were included. Demographic and clinical data were collected. Incidence rates were based on the first hospitalization and expressed as the mean number of new cases per year divided by the average French population during the study period.

Results: A total of 2,205 patients were identified, 42.1% female, with a median age of 64 years. The mean annual incidence was 0.71 per 100,000 persons, markedly higher than previous reports. Autoimmune conditions were present in 15.8% of patients, including myasthenia gravis (13%), aplasia (1%), and systemic lupus erythematosus (1.2%). These preceded TET diagnosis in 22 patients (1%), occurring on average 17.7 months before diagnosis (median: 25 months before), and occurred concurrently or within 2 years after in 221 patients (10%), with a mean delay of 15.4 months (median: 2). A total of 326 patients (14.8%) received immunoglobulin therapy. We assessed second primary malignancies, excluding thoracic tumors (C33, C34, C38, C39) and unspecified secondary cancers (C76–C80) to avoid overlap. Still, 719 patients (32.6%) had additional malignancies, mainly male genital (C60–C63, 118 cases) and hematologic (C81–C96, 110 cases). There were 430 hospitalizations for other cancers in the 2 years preceding TET diagnosis, increasing from 8 per month at 24 months before diagnosis to 42 in the month immediately prior to TET diagnosis. In the 2 years after diagnosis, 850 hospitalizations occurred, including 210 (24.7%) in the first 3 months and 75 (8.8%) in month 2.

Conclusions: This nationwide study shows a higher incidence of TETs than previously reported, with expected rates of autoimmune disease and a surprisingly high frequency of secondary malignancies despite limited follow-up.

Keywords: Thymic epithelial tumors (TETs); incidence; National Health Data

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-25-ab033/coif). V.T.d.M. serves as an unpaid editorial board member of Mediastinum from May 2025 to December 2026. N.G. serves as an unpaid editorial board member of Mediastinum from January 2024 to December 2025. P.A. received payment or honoraria for lectures and presentations from Astra-Zeneca, Netcancer, MSD, Janssen, Roche as well as support for attending meetings from Roche, Pierre Fabre, Eli Lilly and Pfizer. O.M. reports consulting fees from AstraZeneca and Bristol Myers Squibb, honoraria from MSD for a lecture at the Lung Cancer Meeting, ELCC 2025, and support from Lexington for attending ESTS 2025. The other authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. Gustave Roussy Cancer Center is certified to have a permanent regulatory access to SNDS, so this study did not require specific authorization from the French data protection authority. The SNDS is a strictly anonymous database, so informed consent was not needed. This study has been declared prior to data extraction on the Health Data Hub online platform (No. F20230616142940).

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/med-25-ab033
Cite this abstract as: López-Gutiérrez Á, Lolivier A, Benitez JC, Remón J, Rousseau A, Planchard D, Barlesi F, Lavaud P, Gazzah A, Parisi C, Abdayem P, Miliziano D, Zullo L, Gasparro M, Diaz-Jimenez D, Girard N, Thomas de Montpréville V, Mercier O, Foulon S, Besse B. AB033. Thymic cancer in France: a comprehensive analysis of incidence based on French National Healthcare Data—a retrospective observational study. Mediastinum 2025;9:AB033.

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