title: Treatment results and prognostic indicators in thymic epithelial tumors: a clinicopathological analysis of 45 patients.
abstract: BACKGROUND
  Thymomas are rare epithelial tumors arising from thymus gland. This study aims at investigating the clinical presentation, prognostic factors and treatment outcome of forty five patients with thymoma and thymic carcinoma.
  
  
  METHODS
  Forty-five patients being histologically diagnosed with thymoma or thymic carcinoma that were treated and followed-up at a tertiary academic hospital during January 1987 and December 2008 were selected for the present study. Twelve patients were solely treated with surgery, 14 with surgery followed by adjuvant radiotherapy, 12 with sequential combined treatment of surgery, radiotherapy and/or chemotherapy and 7 with non-surgical approach including radiotherapy and/or chemotherapy.  Tumors were classified based on the new World Health Organization (WHO) histological classification.
  
  
  RESULTS
  There were 18 women and 27 men with a median age of 43 years. Twelve patients (26.7%) had stage I, 7 (17.8%) had stage II, 23 (51%) had stage III and 2 (4.5%) had stage IV disease. Tumors types were categorized as type A (n=4), type AB (n=10), type B1 (n=9), type B2 (n=10), type B3 (n=5) and type C (n=7). In univariate analysis for overall survival, disease stage (P=0.001), tumor size (P=0.017) and the extent of surgical resection (P<0.001) were prognostic factors. Regarding the multivariate analysis, only the extent of the surgical resection (P<0.001) was the independent prognostic factor and non-surgical treatment had a negative influence on the survival. The 5-year and 10-year overall survival rates were 70.8% and 62.9%, respectively.
  
  
  CONCLUSIONS
  Complete surgical resection is the most important prognostic factor in patients with thymic epithelial tumors.
authors.affiliation: Department of Radiation Oncology, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Mansour
authors.initials: M
authors.lastname: Ansari
authors.affiliation: Student Research Committee, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Farzin
authors.initials: F
authors.lastname: Dehsara
authors.affiliation: Colorectal Research Center, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Mohammad
authors.initials: M
authors.lastname: Mohammadianpanah
authors.affiliation: Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Mosalaei
authors.affiliation: Colorectal Research Center, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Shapour
authors.initials: S
authors.lastname: Omidvari
authors.affiliation: Colorectal Research Center, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Niloofar
authors.initials: N
authors.lastname: Ahmadloo
keywords: Prognosis; Radiotherapy; Surgery; Thymic neoplasms