Prognostic factors and treatment outcomes for malignant thymoma: A single-center retrospective analysis

This retrospective study evaluated the clinicopathological features, treatment patterns, and prognostic factors influencing long-term outcomes in patients with thymoma and thymic carcinoma at our institution.

We reviewed the electronic medical records of all patients diagnosed with thymic malignancies between 2005 and 2024 at the National Research Institute of Tuberculosis and Lung Diseases in Tehran, Iran. Demographic data, clinical stage, histopathological classification, treatment modality, and survival outcomes were retrieved from the records. Survival analysis was performed using the Kaplan-Meier method, and prognostic factors were assessed with Cox proportional hazards modeling.

A total of 52 patients were identified, including 23 women (44.2%) and 29 men (55.8%), with a median age at diagnosis of 60 years. Myasthenia gravis was present in 9.6% of cases. The estimated 5-year overall survival (OS) for the entire cohort was 53%. Survival differed markedly by histology: patients with thymoma had a 5-year OS of 69%, whereas those with thymic carcinoma had a 5-year OS of 35%. On univariate analysis, histological subtype ( P = 0.03) was significantly associated with OS.

Our findings indicate that histological subtype is a key determinant of long-term survival in thymic malignancies, with thymoma demonstrating substantially better outcomes than thymic carcinoma. The results highlight the prognostic value of accurate histopathological classification and emphasize the critical role of surgical resection-particularly as part of a multimodality treatment strategy-in improving survival. Early diagnosis, precise staging, and individualized treatment planning remain essential to optimize outcomes for patients with these rare tumors.