Thymic carcinoma. Clinical institutional experience with 15 patients.
OBJECTIVE
We retrospectively evaluated 15 patients with thymic carcinoma treated with various modalities and investigated overall management of this disease.


METHODS
From 1983 to 2003, we treated 15 patients with thymic carcinoma (12 squamous cell carcinomas, 2 undifferentiated carcinomas and one adenocarcinoma). According to Masaoka's staging system, they consisted of 2 at stage II, 5 at stage III, 4 at stage IVa and 4 at stage IVb.


RESULTS
Ten patients were histologically diagnosed preoperatively, and 5 patients underwent an exploratory procedure under the diagnosis of thymoma or benign teratoma. Complete resection was performed in 9 patients (2 stage II, 5 stage III and 2 stage IVa), which included 4 patients who received induction therapy, 4 who received postoperative radiation therapy, and 1 who received postoperative chemotherapy. Six patients with unresectable tumors were treated by irradiation (40-60 Gy) with or without chemotherapy. The median survival was 13 months for patients without resection, and 57 months for patients with a complete resection. Total 3-year and 5-year survival rates were 51.9 and 39.0%, respectively.


CONCLUSIONS
We concluded that a complete resection is mainstay of therapy when possible, but chemoradiation therapy being potential benefit in the management of thymic carcinoma. However, considering the high prevalence of advanced stage patients, to establish the effective regimen of induction therapy in the additional multicenter trials should be mandatory.
Takeda
Shin-ichi
S
Department of Thoracic Surgery, Toneyama National Hospital, Toneyama 5-1-1, Toyonaka City, Osaka 560-8552, Japan. stakeda@toneyama.hosp.go.jp
Sawabata
Noriyoshi
N
Inoue
Masayoshi
M
Koma
Masaru
M
Maeda
Hajime
H
Hirano
Hiroshi
H
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D013953:Thymus Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome