title: Surgical treatment and prognosis of thymic squamous cell carcinoma: a retrospective analysis of 105 cases.
abstract: BACKGROUND
  Thymic squamous cell carcinomas are rare malignancies with limited information regarding results of surgery therapy. The objective of the current study was to evaluate their clinical and pathologic features and possible prognostic factors.
  
  
  METHODS
  From February 2003 to December 2010, 105 consecutive surgical patients were enrolled in this study with pathologic confirmed thymic squamous cell carcinoma in Shanghai Chest Hospital. Clinical and pathologic data were retrospectively reviewed. Survival analysis was performed using the Kaplan-Meier and log rank tests. Multivariate analysis was performed using the Cox regression model.
  
  
  RESULTS
  The squamous cell subtype made up 73.4% of the thymic carcinomas and 16.1% of total thymic tumors. Four patients (3.8%) presented with myasthenia gravis. The 5-year overall survival rate and the disease-free survival rate were 59.5% and 57.6%, respectively. On multivariate analysis, only the completeness of resection (hazard ratio 3.692; 95% confidence interval: 1.827 to 7.464; p=0.001) was found to have significant impact on overall survival. Completeness of resection (hazard ratio 2.361; 95% confidence interval: 1.226 to 4.547; p=0.010) and chemotherapy (hazard ratio 0.307; 95% confidence interval: 0.134 to 0.704; p=0.005) were associated with disease-free survival.
  
  
  CONCLUSIONS
  Complete resection not only predicts better overall survival but also extends disease-free interval after resection of thymic squamous cell carcinoma. Our results provide additional evidence supporting an alternative clinical stage specific for thymic carcinoma.
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhao
authors.forename: Heng
authors.initials: H
authors.lastname: Zhao
authors.forename: Dingzhong
authors.initials: D
authors.lastname: Hu
authors.forename: Limin
authors.initials: L
authors.lastname: Fan
authors.forename: Jianxin
authors.initials: J
authors.lastname: Shi
authors.forename: Wentao
authors.initials: W
authors.lastname: Fang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D013934:Thymectomy / Q000379:methods* / Q000401:mortality; D013953:Thymus Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: 13