Surgery for thymic malignancy and nonthymic malignancy incidence: A national longitudinal study.

Area of Science:

• Oncology
• Surgical Oncology
• Epidemiology

Background:

• Previous studies suggest a link between thymic malignancies and other cancers.
• The effect of thymic malignancy surgery on subsequent nonthymic malignancy risk remains debated.

Purpose of the Study:

• To investigate the impact of surgery for thymic malignancies on the risk of developing nonthymic malignancies.
• To evaluate this association in a large-scale, nationwide cohort.

Main Methods:

• Retrospective cohort study using the French National Discharge Database (2014-2023).
• Included adults with a first thymic malignancy (ICD-10: C37), excluding those with prior or early subsequent nonthymic malignancies.
• Analyzed nonthymic malignancy incidence based on surgical treatment for thymic malignancy, using adjusted hazard and odds ratios.

Main Results:

• 72.4% of 3611 thymic malignancy patients underwent surgery.
• Lower incidence of nonthymic malignancies observed in patients who had surgery (30.08 per 1000 person-years) compared to those who did not (53.50 per 1000 person-years).
• Surgery was associated with a reduced risk (aHR 0.85, aOR 0.66), notably for lung cancer (aHR 0.79).

Conclusions:

• Surgical treatment for thymic malignancies is associated with a decreased incidence of subsequent nonthymic malignancies.
• Findings support a potential protective effect of thymic malignancy surgery against other cancers.
• Lung cancer risk reduction was particularly significant post-surgery.