title: Thymic carcinoma: 30 cases at a single institution.
abstract: BACKGROUND
  Thymic carcinoma is a rare and invasive mediastinal neoplasm that often metastasizes. It constitutes a heterogeneous group of tumors that displays different biologic behavior and prognosis. The clinical prognostic factors and treatment of thymic carcinoma are not yet standardized.
  
  
  METHODS
  Thirty patients with thymic carcinoma have been treated at Nagoya City University Hospital since 1983. The clinical and pathologic data of these patients were retrospectively reviewed. Thirteen cases were considered to be unresectable or inoperable and received chemotherapy or chemoradiotherapy. Seventeen cases underwent resection; total in 7 cases and subtotal in 10 cases. Postoperative irradiation was added as adjuvant therapy in the tolerable cases. The most recent five cases received induction chemotherapy.
  
  
  RESULTS
  In 17 of the 30 cases, the patients died. The survival periods in the death cases were from 2.4 to 78.1 months (mean, 32.4 months; median, 21.0 months). The observation periods in the 13 live cases were 6.3 to 232 months (average follow-up, 64.6 months). The 5-year survival rate was 47.5%, and median survival time (MST) was 49.0 months. Cases that underwent total resection showed significantly better prognosis than cases with subtotal resection (p = 0.011) and inoperable cases (p = 0.002). The cases that underwent subtotal resection showed significantly better prognosis than the inoperable cases (p = 0.050). The cases with hematogenous metastasis demonstrated significantly poorer prognosis (p = 0.021), but lymphogenous metastasis was not a significant predictor of poor prognosis. Only resectability was a significant prognostic factor in multivariate Cox regression analysis, and the hazard ratio was 5.123.
  
  
  CONCLUSIONS
  Resectability was the only prognostic factor in thymic carcinoma. We suggest the importance of preoperative precise evaluation to exclude unresectable Masaoka stage IVb disease and expect preoperative chemotherapy or chemoradiotherapy to improve the respectability.
authors.affiliation: Department of Oncology, Immunology, and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. motoki@med.nagoya-cu.ac.jp
authors.forename: Motoki
authors.initials: M
authors.lastname: Yano
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Sasaki
authors.forename: Tomoki
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Yukiue
authors.forename: Osamu
authors.initials: O
authors.lastname: Kawano
authors.forename: Sadao
authors.initials: S
authors.lastname: Suzuki
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Fujii
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006338:Heart Neoplasms / Q000473:pathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate; D013934:Thymectomy / Q000379:methods; D013945:Thymoma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D013953:Thymus Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents