title: Outcome of surgically resected thymic carcinoma: a multicenter experience.
abstract: OBJECTIVE
  Thymic carcinoma (TC) is a rare and invasive mediastinal tumor, with poor prognosis. Most of the previous published papers are single-institution based, reporting small series of patient, sometimes including palliative resection. This study collected patients with TC treated in 5 high-volume Italian Thoracic Surgery Institutions.
  
  
  METHODS
  A multicenter retrospective study of patients operated for TC between 2000 and 2011 was conducted. Exclusion criteria were: Neuroendocrine thymic neoplasms, debulking/palliative resection and tumor biopsy. Cause specific survival (CSS) was the primary endpoint.
  
  
  RESULTS
  Four hundred and seventy-eight patients underwent surgery for thymic malignancies: 40 of them (8.4%) had TC. Eleven (27.5%) received induction chemotherapy because of their radiological invasiveness. A complete resection (R0) was achieved in 36 (90%; 9/11 submitted to induction chemotherapy). Adjuvant radio/chemotherapy was offered to 37 patients, according to the type of surgical resection and tumor invasiveness. Three, 5 and 10-year survival rates were 79%, 75% and 58%. Recurrences developed in 10 patients. R0 resection (p<0.0003) and absence of tumor recurrences (p=0.03) resulted significant prognostic factors at univariate analysis. Independent CSS predictor was the achievement of a complete resection (p<0.05).
  
  
  CONCLUSIONS
  TC is a rare and invasive mediastinal tumor. A multimodal approach is indicated especially in TC invasive forms. The achievement of a complete surgical resection is fundamental to improve survival.
authors.affiliation: University of Torino, Department of Thoracic Surgery, Torino, Italy. Electronic address: pierluigi.filosso@unito.it.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Filosso
authors.affiliation: University of Torino, Department of Thoracic Surgery, Torino, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Guerrera
authors.affiliation: University of Rome Sapienza, Fondazione Eleonora Lorillard Spencer Cenci, S. Andrea Hospital, Rome, Italy.
authors.forename: Angelo Erino
authors.initials: AE
authors.lastname: Rendina
authors.affiliation: University of Torino, Department of Thoracic Surgery, Torino, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bora
authors.affiliation: University of Torino, Department of Thoracic Surgery, Torino, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ruffini
authors.affiliation: San Giovanni Battista Hospital, Unit of Pathology, Torino, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Novero
authors.affiliation: University of Rome Sapienza, Unit of Pathology, S. Andrea Hospital, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ruco
authors.affiliation: University of Rome Sapienza, Policlinico Umberto I, Department of Pathology, Rome, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Vitolo
authors.affiliation: University of Rome Sapienza, Fondazione Eleonora Lorillard Spencer Cenci, Policlinico Umberto I, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Anile
authors.affiliation: University of Rome Sapienza, Fondazione Eleonora Lorillard Spencer Cenci, S. Andrea Hospital, Rome, Italy.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: "Amedeo Avogadro University", Unit of Thoracic Surgery, Novara, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Casadio
authors.affiliation: "Amedeo Avogadro University", Unit of Thoracic Surgery, Novara, Italy.
authors.forename: Ottavio
authors.initials: O
authors.lastname: Rena
authors.affiliation: "Santa Croce e Carle Hospital", Unit of Thoracic Surgery, Cuneo, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Terzi
authors.affiliation: University of Torino, Department of Thoracic Surgery, Torino, Italy.
authors.forename: Paraskevas
authors.initials: P
authors.lastname: Lyberis
authors.affiliation: University of Torino, Department of Thoracic Surgery, Torino, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Oliaro
authors.affiliation: University of Rome Sapienza, Fondazione Eleonora Lorillard Spencer Cenci, Policlinico Umberto I, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Venuta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D056346:Sternotomy; D016019:Survival Analysis; D013903:Thoracic Surgery; D013953:Thymus Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Masaoka staging system; Myasthenia Gravis; Outcome; Surgery; Thymic carcinoma; Thymus