Epidemiology of thymomas and thymic carcinomas in the United States and Germany, 1999-2019

Tiemo Sven Gerber; Stephanie Strobl; Alexander Marx; Wilfried Roth; Stefan Porubsky

doi:10.3389/fonc.2023.1308989

Epidemiology of thymomas and thymic carcinomas in the United States and Germany, 1999-2019

Front Oncol. 2024 Jan 9:13:1308989. doi: 10.3389/fonc.2023.1308989. eCollection 2023.

Authors

Tiemo Sven Gerber¹, Stephanie Strobl¹, Alexander Marx², Wilfried Roth¹, Stefan Porubsky¹

Affiliations

¹ Institute of Pathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
² Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany.

Abstract

Introduction: Mediastinal tumors, particularly non-neuroendocrine thymic epithelial tumors (TET) are relatively uncommon, posing challenges for extensive epidemiological studies. This study presents a comprehensive analysis of these tumors in the United States (US) and Germany (GER) from 1999 to 2019.

Methods: Patients aged 0-19 (n=478) and ≥20 years (n=17,459) diagnosed with malignant tumors of the anterior mediastinum were identified from the Surveillance, Epidemiology, and End Results registry (SEER) and the Zentrum für Krebsregisterdaten (ZfKD) databases.

Results: Among patients aged ≥20 years, TETs accounted for the most prevalent anterior mediastinal tumors (US/GER: 63%/64%), followed by lymphomas (14%/8%). For patients <20 years, predominant tumors included germ cell tumors (42%/14%), lymphomas (38%/53%), and TETs (10%/27%). The overall annual incidence of thymoma was 2.2/2.64 (US/GER) per million inhabitants and for thymic carcinomas 0.48/0.42. The male-to-female ratio was 1:1.09/1.03, and the mean age 59.48 ± 14.89/61.33 ± 13.94. Individuals with thymomas, but not thymic carcinomas, exhibited a 21%/29% significantly heightened risk of developing secondary malignancies compared to controls with non-thymic primary tumors.

Discussion: This study provides a comparative analysis of anterior mediastinal tumors, particularly TETs, in the US and GER over the past two decades. Furthermore, it highlights a significantly elevated incidence of secondary malignancies in thymoma patients.

Keywords: epidemiology; incidence rate; survival; thymic cancer; thymic epithelial tumors; thymoma.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The author (TG) received financial support from the Manfred-Stolte Foundation and is supported by the Clinician Scientist Fellowship “Else Kröner Research College: 2018_Kolleg.05”.