title: Comparison of patterns of relapse in thymic carcinoma and thymoma.
abstract: OBJECTIVE
  Thymic carcinomas are considered to be more aggressive than thymomas and carry a worse prognosis. We reviewed our recent experience with the surgical management of thymic tumors and compared the outcomes and patterns of relapse between patients with thymic carcinoma and those with thymoma.
  
  
  METHODS
  We performed a single-institution retrospective cohort study. Data included patient demographics, stage, treatment, pathologic findings, and postoperative outcomes.
  
  
  RESULTS
  During the period 1995-2006, 120 patients with thymic tumors underwent surgical intervention, including 23 patients with thymic carcinoma and 97 patients with thymoma, as classified according to the World Health Organization 2004 histologic classification. The overall 5-year survival was significantly different between patients with thymic carcinoma and those with thymoma (thymic carcinoma, 53%; thymoma, 89%; P = .01). Data on relapse were available for 112 patients. The progression-free 5-year survival was also significantly different between patients with thymic carcinoma and those with thymoma (thymic carcinoma, 36%; thymoma, 75%; P < .01). Using multivariate analysis, thymic carcinoma and incomplete resection were found to be independent predictors of progression-free survival. Relapses in patients with thymic carcinoma tended to occur earlier, and occurred significantly more frequently at distant sites than in patients with thymoma (60% vs 13%, P = .01).
  
  
  CONCLUSIONS
  Patterns of relapse differ significantly between patients with thymic carcinoma and those with thymoma, with lower progression-free survival, earlier onset, and more distant relapses in patients with thymic carcinoma. Given the greater propensity for distant failures, the inclusion of systemic therapy in the treatment of thymic carcinoma might take on greater importance. Despite significantly higher rates of distant relapse, good overall survival in patients with thymic carcinoma can be achieved.
authors: Department of Surgery, Thoracic Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. huangj@mskcc.org
authors: James
authors: J
authors: Huang
authors: Nabil P
authors: NP
authors: Rizk
authors: William D
authors: WD
authors: Travis
authors: Gregory J
authors: GJ
authors: Riely
authors: Bernard J
authors: BJ
authors: Park
authors: Manjit S
authors: MS
authors: Bains
authors: Joseph
authors: J
authors: Dycoco
authors: Raja M
authors: RM
authors: Flores
authors: Robert J
authors: RJ
authors: Downey
authors: Valerie W
authors: VW
authors: Rusch
mesh_terms: D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D015996:Survival Rate; D013945:Thymoma / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D013953:Thymus Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery