Ciência e terapia do câncer

Thymomas and Thymic Cancers: About a Moroccan Population

Abstract

Zineb Benbrahim, Hajar Bettach, Lamiyae Amaadour, Fatimazahra El M’Rabet, Samia Arifi and Nawfel Mellas

Background: Thymic epithelial tumors are rare tumors with variable prognosis. They include thymomas and thymic carcinomas. The therapeutic strategy depends on the anatomo-clinical stage. However, significant differences are observed in therapeutic response and survival. The aim of this study is to describe the epidemiological, clinical, pathological characteristics, therapeutic results and the prognosis of thymomas and thymic carcinomas.
Materials and methods: This is a retrospective study of a series of thymomas and thymic carcinomas collected at the Medical Oncology Department of the Hassan II Hospital in Fez during a period of 7 years [October 2010 to May 2017]. Epidemiological, clinical, pathological and therapeutic results were analyzed by Excel. Disease-free survival, progression-free survival and overall survival were calculated using the Kaplan-Meier method.
Results: Thymomas represent a frequency of 0.1% of all cancers treated in the Oncology Department. The median age of the study population was 49.64 years [22-81 years] and the sex ratio was 2.4. Dyspnea and chest pain were the most common revealing symptoms. Myasthenia represents the essential paraneoplastic syndrome encountered in our series. Majority of cases were diagnosed at locally advanced and metastatic stages (82.3% of cases). 70.6% of cases were thymomas and 29.4% thymic carcinomas. Two cases in this study underwent surgery, it was complete and without microscopic residue in both cases. Two patients received radiotherapy adjuvant to surgery or after neoadjuvant chemotherapy. Chemotherapy was prescribed in 13 patients mostly in a palliative setting. Two patients were cured, 8 patients died from disease, 3 patients were lost of view, the remaining patients were in locoregional and distance control.
Conclusion: Thymic epithelial tumors, including thymomas and thymic carcinomas, are rare tumors and belong to the group of orphan tumors. They present specific problems, from pathological diagnosis to the treatment requiring multidisciplinary therapeutic strategy.