AB002. Patterns of lymph node metastasis in patients with neuroendocrine thymic tumors: a retrospective study of 72 cases
Abstract

AB002. Patterns of lymph node metastasis in patients with neuroendocrine thymic tumors: a retrospective study of 72 cases

Wen-Qing Zhang, Qin Zhang, Chang-Lu Wang

Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai, China

Correspondence to: Chang-Lu Wang, MD. Department of Radiation Oncology, Shanghai Chest Hospital, No. 241, West Huaihai Road, Shanghai 200030, China. Email: luise2w@msn.com.

Background: There is a high frequency of lymph node (LN) metastasis in patients with neuroendocrine thymic tumors (NETTs). In this study, we analyzed the patterns of LN metastasis in a big cohort of NETT patients.

Methods: From September 2008 to December 2022, 72 patients who were pathologically diagnosed as NETT in our hospital were enrolled in this study. LN metastasis was confirmed by the following criteria: (I) pathological examination of LN specimen from surgery or biopsy; (II) continuous enlargement of LN on routine follow-up computed tomography (CT) images; (III) LN showing similar standardized uptake value (SUV) uptake on positron emission tomography (PET)-CT as mediastinal primary tumor.

Results: There were 55 male and 17 female patients with a median age of 55 (range, 22–70) years. Pathologic subtype distributions were: typical carcinoid (n=9), atypical carcinoid (n=50), high grade NETT (n=13). During a median follow up time of 64 months, a total of 67 (93%) patients developed LN metastasis. The most frequent sites were: lower paratracheal area (from aorta arc level to carina level): 51.4%; supraclavicular area: 48.6%; sub-carinal area: 43.1%; upper paratracheal area (from thoracic inlet to above aorta arc): 36%; hilar area: 33.3%, supradiaphragmatic area: 30.6%, and other less frequent areas. The median progression-free survival time was 27 months. The 5-year overall survival rate was 52.2%. In the typical carcinoid group, the accumulated LN metastasis rate was 100% (9/9), and it was 92% (46/50) and 92.3% (12/13) in the atypical carcinoid group and in the high-grade NETT group, respectively.

Conclusions: LN metastasis was the most frequent failure type (more than pleura, bone, lung, etc.) in NETT patients. Our results may provide reference for proper extension of LN dissection in NETT surgery. Additionally, an optimal post-operative radiotherapy target design may possibly reduce LN metastasis, and improve long-term survival subsequently.

Keywords: Neuroendocrine thymic tumor (NETT); lymph node metastasis; surgery; radiotherapy

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-24-ab002/coif). 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 (as revised in 2013). The study was approved by the institutional ethics board of Shanghai Chest Hospital (No. IS24170) and individual consent for this retrospective analysis was waived.

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-24-ab002
Cite this abstract as: Zhang WQ, Zhang Q, Wang CL. AB002. Patterns of lymph node metastasis in patients with neuroendocrine thymic tumors: a retrospective study of 72 cases. Mediastinum 2024;8:AB002.

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