title: Invasion of the great vessels or atrium predicts worse prognosis in thymic carcinoma.
abstract: OBJECTIVE
  We evaluated treatment outcomes of thymic carcinomas to determine prognostic factors for survival.
  
  
  METHODS
  Between May 1988 and May 2009, 41 patients had pathologic diagnosis of thymic carcinoma in Seoul National University Hospital, Seoul, Korea. Of these, 40 patients were followed up to 188 months after treatment. The mean age of all patients was 58.3 years and male to female ratio was 23 to 17.
  
  
  RESULTS
  Among 30 patients who underwent surgical resection, 26 achieved R0 resection and postoperative radiotherapy (PORT) was performed in 22 patients (73%). Various chemotherapeutic regimens were given with local treatment modalities, surgery and/or radiotherapy, in 12 patients. The 5-year locoregional control (LRC), distant metastasis-free survival, progression-free survival (PFS), and overall survival were 79.4%, 53.0%, 42.6%, and 63.6%, respectively. Patients with Masaoka stage I or II showed excellent prognosis of 5-year PFS around 90%. In advanced stages, invasion of the great vessels or atrium by thymic carcinomas was negative prognostic factor for PFS in univariate analysis. Lymph node involvement was statistically significant factor for LRC and PFS. Local or regional recurrence was infrequent after surgical resection followed by PORT, while distant metastasis was the major component of treatment failure.
  
  
  CONCLUSIONS
  Complete resection followed by PORT provided remarkable local control without severe acute toxicities in patients with stage II and favorable stage III thymic carcinoma. Invasion of the great vessels or atrium was statistically significant prognostic factor for PFS.
authors.affiliation: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Keun-Yong
authors.initials: KY
authors.lastname: Eom
authors.forename: Hak Jae
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hong-Gyun
authors.initials: HG
authors.lastname: Wu
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Dae Seog
authors.initials: DS
authors.lastname: Heo
authors.forename: Young Whan
authors.initials: YW
authors.lastname: Kim
keywords: Great vessel invasion; Prognostic factor; Survival; Thymic carcinoma