title: Thymic carcinoma: involvement of great vessels indicates poor prognosis.
abstract: BACKGROUND
  Thymic carcinoma is a rare, indolent, and invasive cancer. This study investigated the treatment results of thymic carcinoma and clinical prognostic factors.
  
  
  METHODS
  From June 1988 to January 2002, 38 patients were enrolled in this study with the diagnosis of thymic carcinoma in the Cheng-Kung University Hospital based on Rosai's and Muller-Hermelink's classification. Clinical and pathologic data were retrospectively reviewed. Survival analysis was performed using the Kaplan-Meier, log rank, and Wilcoxon tests. Statistical significance was defined as p < 0.05.
  
  
  RESULTS
  Pathology revealed 14 poorly differentiated, 6 moderately differentiated, and 8 well-differentiated squamous cell carcinomas; 8 lymphoepithelioma-like carcinomas; and 2 other carcinomas. Pathologic staging using the Masaoka system included 6 stage II, 23 stage III, and 9 stage IV patients. Six biopsies, five debulkings, and 27 complete resections were performed. All patients were followed from 15 months to 10 years 9 months, with an average of 53.8 months. Median survival time was 81 months, and median recurrence time was 52 months. Eighteen patients are still alive, and 7 are alive with disease. Well-differentiated squamous cell carcinoma had better prognosis than other carcinomas (p = 0.022). Complete resection significantly increased survival rate (p < 0.001). Tumor invasion of the superior vena cava, pulmonary vessels, or aorta were significant predictors for poor prognosis (p = 0.016, 0.002, and 0.002, respectively).
  
  
  CONCLUSIONS
  Only patients with thymic carcinoma who underwent complete resection had long-term survival. Prognosis of thymic carcinoma seemed mainly dependent on tumor invasion of the great vessels.
authors.affiliation: Institute of Clinical Medicine, Taiwan, Tainan, China
authors.forename: Yau-Lin
authors.initials: YL
authors.lastname: Tseng
authors.forename: Shan-Tair
authors.initials: ST
authors.lastname: Wang
authors.forename: Ming-Ho
authors.initials: MH
authors.lastname: Wu
authors.forename: Mu-Yen
authors.initials: MY
authors.lastname: Lin
authors.forename: Wu-Wei
authors.initials: WW
authors.lastname: Lai
authors.forename: Fen-Fen
authors.initials: FF
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D011651:Pulmonary Artery / Q000473:pathology; D011667:Pulmonary Veins / Q000473:pathology; D012189:Retrospective Studies; D015996:Survival Rate; D013945:Thymoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D013953:Thymus Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D014683:Vena Cava, Superior / Q000473:pathology*