AB054. Survival outcomes in thymic carcinoma: a single-center experience
Original Research

AB054. Survival outcomes in thymic carcinoma: a single-center experience

Erica Pietroluongo1, Martina Di Meo1, Lucia Salatiello1, Carmine Caso1, Giovannella Palmieri1, Pietro De Placido2, Roberto Bianco1, Alberto Servetto1

1Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy; 2Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy

Correspondence to: Erica Pietroluongo, MD, PhD. Department of Clinical Medicine and Surgery, University Federico II, Via Pansini 5, Naples, 80131, Italy. Email: erica.pietroluongo@gmail.com.

Background: Thymic carcinomas (TCs) are rare neoplasms of the anterior mediastinum, accounting for 14% to 22% of thymic epithelial tumors. They are distinguished by aggressive biological behavior, frequent metastatic spread, and a poorer prognosis than thymomas. Despite therapeutic advances, prognostic determinants remain unexplored, particularly in real-world settings. We aimed to describe overall survival (OS) in a monocentric cohort of patients with TC and explore its association with key clinical and pathological variables.

Methods: We conducted a retrospective analysis of 30 patients with a diagnosis of TC referred to the University of Naples Federico II from January 2007 to December 2022. Data collected included age at diagnosis, sex, surgery, disease stage, and presence of autoimmune conditions. OS was defined as the time from histological diagnosis to death from any cause or last follow-up (data cut-off: April 29, 2025). Survival analyses were performed using the Kaplan-Meier method and compared with the log-rank test.

Results: The median age at diagnosis was 55 years (range, 32–77 years), with 12 (40%) females and 18 (60%) males. According to the Masaoka-Koga system, disease stage was III in 5 patients (17%), IVA in 6 (20%), and IVB in 19 (63%). Only 5 patients underwent thymectomy (16.6%). Autoimmune conditions were present in 13 patients, including 9 with Good’s syndrome, 3 with myasthenia gravis (MG), and 1 with rheumatoid arthritis. Among these patients, three were found to have a concurrent B3 thymoma component, and two of these presented with MG. The median OS for the study cohort was 41.8 months. No association between OS and sex was observed (P=0.64). In contrast, any autoimmune condition was significantly associated with prolonged survival (median OS: 137.5 vs. 46.8 months; P=0.02).

Conclusions: In this single-center cohort of patients with TC, autoimmune conditions were associated with significantly prolonged OS. It may be linked to an underlying B3 thymoma component or the lack of systematic screening for autoimmunity in TC. These findings suggest that autoimmunity may identify a clinically distinct subset of patients with more favorable outcomes and warrant further investigation in larger, prospective cohorts.

Keywords: Thymic carcinomas (TCs); survival outcomes; autoimmune disorders

Acknowledgments

E.P. is supported by a Scholarship from “Associazione TUTOR”, year 2024-2025.

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-ab054/coif). E.P. is supported by a Scholarship from “Associazione TUTOR”, year 2024–2025. The 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. The study was approved by the Institutional Review Board of the University of Naples Federico II (Protocol IRB approval n. 76.21). All patients provided written informed consent before enrollment according to the institutional guidelines and the Declaration of Helsinki.

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-ab054
Cite this abstract as: Pietroluongo E, Di Meo M, Salatiello L, Caso C, Palmieri G, De Placido P, Bianco R, Servetto A. AB054. Survival outcomes in thymic carcinoma: a single-center experience. Mediastinum 2025;9:AB054.

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