Time-Dependent Alteration in the Causes of Death in LongTerm Thymoma Survivors

Xu K, Sun H, Jiao R, Liang J and Jiang W

Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China

^*Correspondance to: Wei Jiang 

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Abstract:

Objectives: It was suggested that thymoma is a chronic disease and that cardiovascular disease is the most common non-cancer-related cause of death in survivors after thoracic radiotherapy. We aimed to evaluate time-related survival and causes of death in patients with thymoma. Methods: The survival and cause of death in patients with thymoma were assessed using the Surveillance, Epidemiology, and End Results data. We performed conditional survival, annual hazard rate, and Fine-Gray competing risk analyses. Results: We identified 3,105 patients with thymoma. The 10-year overall survival and cancer-specific survival rates were 55.5% (95% CI, 53.4-57.6%) and 74.4% (95% CI, 72.4-76.3%), respectively. The annual smoothed hazard for all-cause mortality increased steadily, while that of thymoma-related mortality decreased by the 4th year and was surpassed by other causes starting at 4.5 years. The annual hazard of thymoma-related mortality remained at about 1% to 2% between years 5 and 25. Conditional survival showed a similar trend. The 10-, 15-, and 25-year cumulative incidences of the most common death causes were 23.1, 28.5, and 31.8% for thymoma, 5.4, 8.3, and 11.8% for heart disease, and 3.9, 7.0, and 10.8% for a second cancer, respectively. Heart disease was the leading nonthymoma cause of death in 5-year survivors and posed a high mortality risk in 10-year survivors aged ≥ 65 years or who received radiotherapy (adjusted P<0.001, P=0.015). Conclusion: The risk of cancer-specific and non-cancer-specific causes of death shifted over time in patients with thymoma. Non-cancer-specific causes, particularly heart disease, were major competing causes of death that increased with survival.

Keywords:

Thymoma; Conditional survival; Annual hazard; Heart disease

Cite the Article:

Xu K, Sun H, Jiao R, Liang J, Jiang W. Time-Dependent Alteration in the Causes of Death in Long-Term Thymoma Survivors. Clin Oncol. 2024;9: 2114..