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Diagnostic and prognostic relevance of inflammatory markers in surgically treated thymic epithelial tumors : An international multicenter study

Megyesfalvi, Evelyn ; Ghimessy, Aron ; Bauer, Jonas ; Pipek, Orsolya ; Saghi, Kevin ; Gellert, Aron ; Fillinger, Janos ; Okumus, Ozlem ; Teglas, Vivien and Ganofszky, Erna , et al. (2025) In Lung Cancer 200.
Abstract

Background: Complementary prognostic markers are needed in thymic epithelial tumors (TETs) to aid patient stratification and determine the most appropriate follow-up strategies. This study aimed to assess the diagnostic and prognostic relevance of blood-based inflammatory markers in a large cohort of surgically treated TET patients. Material and Methods: A total of 743 TET patients who underwent surgical resection between 1999–2021 were included in this multicenter study. Inflammatory markers were recorded from the most recent preoperative blood cell count prior to surgery. Measured variables were rescaled and harmonized to obtain comparable values across the participating centers. Results: Preoperative CRP was significantly higher in... (More)

Background: Complementary prognostic markers are needed in thymic epithelial tumors (TETs) to aid patient stratification and determine the most appropriate follow-up strategies. This study aimed to assess the diagnostic and prognostic relevance of blood-based inflammatory markers in a large cohort of surgically treated TET patients. Material and Methods: A total of 743 TET patients who underwent surgical resection between 1999–2021 were included in this multicenter study. Inflammatory markers were recorded from the most recent preoperative blood cell count prior to surgery. Measured variables were rescaled and harmonized to obtain comparable values across the participating centers. Results: Preoperative CRP was significantly higher in TET patients with increased tumor size (vs. those with T1 tumors, p = 0.035). Likewise, neutrophil-to-lymphocyte ratio (NLR) (p = 0.002) and platelet-to-lymphocyte ratio (PLR) (p < 0.001) were both significantly higher in thymic carcinomas than in thymomas. Notably, increased NLR and PLR were mainly attributed to significantly decreased lymphocyte levels in thymic carcinoma patients. Concerning survival outcomes, we found that elevated PLR and fibrinogen influenced overall survival (OS) (p = 0.002 and p = 0.018, respectively) and cause-specific survival (CSS) (p = 0.002 and p = 0.009, respectively) independently of other variables in our multivariate models, and they constituted negative prognosticators in TETs. Elevated CRP had an independent negative impact only on OS. Although elevated NLR was linked with impaired prognosis in our univariate model (p = 0.008), its independent prognostic significance could not be validated. Conclusions: Using the so-far largest cohort of surgically treated TET patients, our study demonstrates that CRP, PLR, and NLR have diagnostic significance in TETs, while elevated PLR and fibrinogen constitute independent negative prognosticators for OS and CSS. Accordingly, the current multicenter study offers additional guidance in developing personalized surveillance protocols in thymoma and thymic carcinoma.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Inflammatory markers, Prognosis, Thymic carcinoma, Thymoma
in
Lung Cancer
volume
200
article number
108111
publisher
Elsevier
external identifiers
  • scopus:85216289436
  • pmid:39889465
ISSN
0169-5002
DOI
10.1016/j.lungcan.2025.108111
language
English
LU publication?
yes
id
83140e75-8fd8-4e58-98d2-cb0b19616621
date added to LUP
2025-04-07 12:28:46
date last changed
2025-07-15 04:45:07
@article{83140e75-8fd8-4e58-98d2-cb0b19616621,
  abstract     = {{<p>Background: Complementary prognostic markers are needed in thymic epithelial tumors (TETs) to aid patient stratification and determine the most appropriate follow-up strategies. This study aimed to assess the diagnostic and prognostic relevance of blood-based inflammatory markers in a large cohort of surgically treated TET patients. Material and Methods: A total of 743 TET patients who underwent surgical resection between 1999–2021 were included in this multicenter study. Inflammatory markers were recorded from the most recent preoperative blood cell count prior to surgery. Measured variables were rescaled and harmonized to obtain comparable values across the participating centers. Results: Preoperative CRP was significantly higher in TET patients with increased tumor size (vs. those with T1 tumors, p = 0.035). Likewise, neutrophil-to-lymphocyte ratio (NLR) (p = 0.002) and platelet-to-lymphocyte ratio (PLR) (p &lt; 0.001) were both significantly higher in thymic carcinomas than in thymomas. Notably, increased NLR and PLR were mainly attributed to significantly decreased lymphocyte levels in thymic carcinoma patients. Concerning survival outcomes, we found that elevated PLR and fibrinogen influenced overall survival (OS) (p = 0.002 and p = 0.018, respectively) and cause-specific survival (CSS) (p = 0.002 and p = 0.009, respectively) independently of other variables in our multivariate models, and they constituted negative prognosticators in TETs. Elevated CRP had an independent negative impact only on OS. Although elevated NLR was linked with impaired prognosis in our univariate model (p = 0.008), its independent prognostic significance could not be validated. Conclusions: Using the so-far largest cohort of surgically treated TET patients, our study demonstrates that CRP, PLR, and NLR have diagnostic significance in TETs, while elevated PLR and fibrinogen constitute independent negative prognosticators for OS and CSS. Accordingly, the current multicenter study offers additional guidance in developing personalized surveillance protocols in thymoma and thymic carcinoma.</p>}},
  author       = {{Megyesfalvi, Evelyn and Ghimessy, Aron and Bauer, Jonas and Pipek, Orsolya and Saghi, Kevin and Gellert, Aron and Fillinger, Janos and Okumus, Ozlem and Teglas, Vivien and Ganofszky, Erna and Bogos, Krisztina and Renyi-Vamos, Ferenc and Megyesfalvi, Zsolt and Aigner, Clemens and Hegedus, Balazs and Dome, Balazs and Moser, Bernhard}},
  issn         = {{0169-5002}},
  keywords     = {{Inflammatory markers; Prognosis; Thymic carcinoma; Thymoma}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Lung Cancer}},
  title        = {{Diagnostic and prognostic relevance of inflammatory markers in surgically treated thymic epithelial tumors : An international multicenter study}},
  url          = {{http://dx.doi.org/10.1016/j.lungcan.2025.108111}},
  doi          = {{10.1016/j.lungcan.2025.108111}},
  volume       = {{200}},
  year         = {{2025}},
}