{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:18:46Z","timestamp":1792001926654,"version":"4.4.0"},"reference-count":38,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Neuroendocrine tumors of a thymus (NETTs) are rare, accounting for approximately 2\u20135% of all thymic epithelial tumors, and have a poor prognosis due to frequent lymph nodes or distant metastasis. Methods: We retrospectively reviewed the clinicopathological background and outcomes of 40 patients who underwent resection or surgical biopsy with histologically diagnosed NETTs from 1986 to 2022. Results: The most common pathological type was atypical carcinoid. Surgical resection was performed in 35 patients, with lymph node dissection in 33 and surgical biopsy in five. The overall survival (OS) rate for all patients was 81.4% and 52.3% at 5 and 10 years, respectively. The 2-year survival rate was 20% for the biopsy group, which was significantly worse than that of the resected group (p &lt; 0.001). The relapse-free survival rates were 61.7% and 37.6% at 5 and 10 years, respectively, in 34 patients with complete resection. The univariate analysis revealed better the OS rate in the resected cases but with no significant differences between histological grade, lymph node metastasis, tumor size, or Ki67 index. Conclusions: Surgical complete resection is considered to improve prognosis regardless of histologic type. NETTs frequently develop lymph node metastasis, thus, lymph node dissection seems necessary for complete resection.<\/jats:p>","DOI":"10.3390\/cancers15082370","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T03:20:39Z","timestamp":1681874439000},"page":"2370","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Significance of the Surgical Treatment with Lymph Node Dissection for Neuroendocrine Tumors of Thymus"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3509-9536","authenticated-orcid":false,"given":"Naoko","family":"Ose","sequence":"first","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichiro","family":"Funaki","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2955-1490","authenticated-orcid":false,"given":"Takashi","family":"Kanou","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3800-1327","authenticated-orcid":false,"given":"Eriko","family":"Fukui","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiichi","family":"Morii","sequence":"additional","affiliation":[{"name":"Department of Pathology, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2540-5288","authenticated-orcid":false,"given":"Yasushi","family":"Shintani","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1200\/JCO.2007.15.4377","article-title":"One hundred years after \u201ccarcinoid\u201d: Epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States","volume":"26","author":"Yao","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_2","unstructured":"Travis, W.D., Brambilla, E., M\u00fcller-Hermelink, H.K., and Harris, C.C. (2004). Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart (WHO Classification of Tumours), IARC Press."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1097\/SLA.0b013e3181dd4ec4","article-title":"Thymic neuroendocrine tumors: A SEER database analysis of 160 patients","volume":"251","author":"Gaur","year":"2010","journal-title":"Ann. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1097\/JTO.0000000000000654","article-title":"The 2015 World Health Organization Classification of Tumors of the Thymus: Continuity and Changes","volume":"10","author":"Marx","year":"2015","journal-title":"J. Thorac. Oncol."},{"key":"ref_5","unstructured":"WHO Classification of Tumours Editorial Board (2021). Thoracic Tumours."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1093\/ejcts\/ezw107","article-title":"Comparison of outcomes between neuroendocrine thymic tumours and other subtypes of thymic carcinomas: A joint analysis of the European Society of Thoracic Surgeons and the International Thymic Malignancy Interest Group","volume":"50","author":"Filosso","year":"2016","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.athoracsur.2012.03.062","article-title":"Primary neuroendocrine tumors of the thymus: A multicenter experience of 35 patients","volume":"94","author":"Cardillo","year":"2012","journal-title":"Ann. Thorac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1309\/3PDN-PMT5-EQTM-H0CD","article-title":"Neuroendocrine carcinomas (carcinoid tumor) of the thymus. A clinicopathologic analysis of 80 cases","volume":"114","author":"Moran","year":"2000","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/0003-4975(90)90087-M","article-title":"Carcinoid tumors of thymus","volume":"50","author":"Economopoulos","year":"1990","journal-title":"Ann. Thorac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jtcvs.2014.08.061","article-title":"Outcome of primary neuroendocrine tumors of the thymus: A joint analysis of the International Thymic Malignancy Interest Group and the European Society of Thoracic Surgeons databases","volume":"149","author":"Filosso","year":"2015","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.lungcan.2012.12.001","article-title":"Treatment, prognostic markers and survival in thymic neuroendocrine tumors. a study from a single tertiary referral centre","volume":"79","author":"Crona","year":"2013","journal-title":"Lung Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/S0022-5223(96)70409-9","article-title":"Thymic neuroendocrine carcinoma (carcinoid): A clinicopathologic study of fourteen cases","volume":"111","author":"Macchiarini","year":"1996","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/S0003-4975(01)03032-6","article-title":"Neuroendocrine tumors of the thymus: A clinicopathological and prognostic study","volume":"72","author":"Gal","year":"2001","journal-title":"Ann. Thorac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.3892\/ol.2014.2490","article-title":"Primary neuroendocrine tumors of the thymus: Clinical review of 22 cases","volume":"8","author":"Song","year":"2014","journal-title":"Oncol. Lett."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/icvts\/ivx265","article-title":"Results of treatment for thymic neuroendocrine tumours: Multicentre clinicopathological study","volume":"26","author":"Ose","year":"2018","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1186\/s13023-022-02366-x","article-title":"Real-world clinicopathological features and outcome of thymic neuroendocrine tumors: A retrospective single-institution analysis","volume":"17","author":"Chen","year":"2022","journal-title":"Orphanet. J. Rare Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1159\/000472255","article-title":"Thymic Neuroendocrine Neoplasms: Biological Behaviour and Therapy","volume":"105","author":"Jia","year":"2017","journal-title":"Neuroendocrinology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4033","DOI":"10.21037\/jtd-20-1065","article-title":"Comparison of the progression-free survival between robot-assisted thymectomy and video-assisted thymectomy for thymic epithelial tumors: A propensity score matching study","volume":"12","author":"Li","year":"2020","journal-title":"J. Thorac. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1016\/j.athoracsur.2019.01.006","article-title":"Lymph Node Involvement and the Surgical Treatment of Thymic Epithelial and Neuroendocrine Carcinoma","volume":"107","author":"Cheufou","year":"2019","journal-title":"Ann. Thorac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1378\/chest.124.1.141","article-title":"A clinicopathologic study of 12 neuroendocrine tumors arising in the thymus","volume":"124","author":"Tiffet","year":"2003","journal-title":"Chest"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s002689900029","article-title":"Pulmonary and thymic carcinoid tumors","volume":"20","author":"Dusmet","year":"1996","journal-title":"World J. Surg."},{"key":"ref_22","unstructured":"Brierley, J.D., Gospodarowicz, M.K., and Wittekind, C. (2017). Union for International Cancer Control (UICC) TNM Classification of Malignant Tumors, Wiley-Blackwell. [8th ed.]."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1097\/JTO.0000000000000290","article-title":"The IASLC\/ITMIG Thymic Epithelial Tumors Staging Project: Proposal for an evidence-based stage classification system for the forthcoming (8th) edition of the TNM classification of malignant tumors","volume":"9","author":"Detterbeck","year":"2014","journal-title":"J. Thorac. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1097\/MPA.0b013e3181ec1380","article-title":"North American Neuroendocrine Tumor Society (NANETS): NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: Well-differentiated neuroendocrine tumors of the thorax (includes lung and thymus)","volume":"39","author":"Phan","year":"2010","journal-title":"Pancreas"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1016\/S0003-4975(02)03547-6","article-title":"Primary neuroendocrine tumors of the thymus. See comment in PubMed Commons below","volume":"74","author":"Chaer","year":"2002","journal-title":"Ann. Thorac. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1210\/jc.2002-021314","article-title":"Prospective study of thymic carcinoids in patients with multiple endocrine neoplasia type 1","volume":"88","author":"Gibril","year":"2003","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1210\/jc.2004-1155","article-title":"Thymic neuroendocrine carcinoma (carcinoid) in multiple endocrine neoplasia type 1 syndrome: The Italian series","volume":"90","author":"Ferolla","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.lungcan.2014.08.008","article-title":"Is (18)F-FDG PET useful in predicting the WHO grade of malignancy in thymic epithelial tumors? A meta-analysis","volume":"86","author":"Treglia","year":"2014","journal-title":"Lung Cancer"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1378\/chest.125.6.2368-a","article-title":"PET scanning in thymic neuroendocrine tumors","volume":"125","author":"Whitaker","year":"2004","journal-title":"Chest"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1007\/s12149-014-0900-3","article-title":"Lesion-based analysis of (18)F-FDG uptake and (111) In-Pentetreotide uptake by neuroendocrine tumors","volume":"28","author":"Kubota","year":"2014","journal-title":"Ann. Nucl. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2967\/jnumed.116.178095","article-title":"Comparison of the Impact of 68Ga-DOTATATE and 18F-FDG PET\/CT on Clinical Management in Patients with Neuroendocrine Tumors","volume":"58","author":"Panagiotidis","year":"2017","journal-title":"J. Nucl. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/MNM.0000000000001158","article-title":"Value of 18F-FDG PET\/computed tomography in predicting the simplified WHO grade of malignancy in thymic epithelial tumors","volume":"41","author":"Zhao","year":"2020","journal-title":"Nucl. Med. Commun."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/JTO.0000000000000128","article-title":"Thymic carcinoma: A cohort study of patients from the European society of thoracic surgeons database","volume":"9","author":"Ruffini","year":"2014","journal-title":"J. Thorac. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jtcvs.2014.09.124","article-title":"Thymic carcinoma outcomes and prognosis: Results of an international analysis","volume":"149","author":"Ahmad","year":"2015","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1093\/ejcts\/ezv239","article-title":"Long-term outcome and prognostic factors of surgically treated thymic carcinoma: Results of 306 cases from a Japanese Nationwide Database Study","volume":"49","author":"Hishida","year":"2016","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Comacchio, G.M., Dell\u2019Amore, A., Marino, M.C., Russo, M.D., Schiavon, M., Mammana, M., Faccioli, E., Lorenzoni, G., Gregori, D., and Pasello, G. (2021). Vascular involvement in thymic epithelial tumors: Surgical and oncological outcomes. Cancers, 13.","DOI":"10.3390\/cancers13133355"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e85","DOI":"10.1016\/j.athoracsur.2013.04.107","article-title":"Multimodality therapy for large cell neuroendocrine carcinoma of the thymus","volume":"96","author":"Ose","year":"2013","journal-title":"Ann. Thorac. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S1491","DOI":"10.21037\/jtd.2017.08.18","article-title":"Neuroendocrine tumors of the thymus: The oncologist point of view","volume":"9","author":"Girard","year":"2017","journal-title":"J. Thorac. Dis."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/8\/2370\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:18:43Z","timestamp":1760123923000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/8\/2370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,19]]},"references-count":38,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["cancers15082370"],"URL":"https:\/\/doi.org\/10.3390\/cancers15082370","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,19]]}}}