Central nervous system metastases in thymic epithelial tumors: a brief report of real-world insight from RYTHMIC.
Fiche publication
Date publication
août 2021
Journal
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
Auteurs
Membres identifiés du Cancéropôle Est :
Dr CLEMENT-DUCHENE Christelle, Pr FALCOZ Pierre-Emmanuel, Pr WESTEEL Virginie
Tous les auteurs :
Benitez JC, Boucher ME, Dansin E, Kerjouan M, Bigay-Game L, Pichon E, Thillays F, Falcoz PE, Lyubimova S, Oulkhouir Y, Calcagno F, Thiberville L, Clément-Duchêne C, Westeel V, Missy P, Thomas P, Maury JM, Molina T, Girard N, Besse B
Lien Pubmed
Résumé
Thymic epithelial tumors (TETs) are rare malignancies ranging from indolent thymoma A to aggressive thymic carcinomas (TC). Brain metastases are extremely infrequent for TETs and have only been described in case reports or small single-center series. RYTHMIC (Réseau tumeurs THYMiques et Cancer) is a French nationwide network mandated to systematically review every TET case, and prospectively includes all consecutive patients discussed by national or regional tumor boards. We analyzed patients with TETs and CNS metastasis during their cancer history from this large French registry. Over an 8-year period, 2909 patients were included in the database, including 248 TC (8.5%). Fourteen patients had central nervous system (CNS) metastases, 5 (36%) at diagnosis and 9 (64%) at relapse. Among them, 12 (86%) patients had a diagnosis of TC and 2 (14%) had thymoma A and B3. Surgical biopsies were performed and the histological subtype for non-TC tumors was centrally confirmed. Median overall survival (OS) was 22 months (95%CI 9.8-34.2), with longer, albeit non-significant, OS when CNS metastases were present at diagnosis vs relapse (not reached vs 17 months; p=0.29); median progression-free survival was 13 vs 8 months (p=0.06) respectively. A higher risk of death (HR=5.34, 95%CI [1.3-21.9]; p=0.02) and relapse (HR=1.89, 95%CI [0.9-3.7]; p=0.06) was observed for patients suffering from TC with brain metastases compared to those without CNS extension. CNS disease was extremely rare in our TET cohort (0.48%), reported at both diagnosis and progression, present primarily in TC, with prevalence rising to 4.9%.
Référence
J Thorac Oncol. 2021 Aug 26;: