title: Thymic epithelial tumors: prognostic determinants among clinical, histopathologic, and computed tomography findings.
abstract: BACKGROUND
  The Masaoka-Koga staging system has been known as the strongest prognostic factor for both survival and recurrence of thymic epithelial tumor (TET). The purpose of our study was to find prognostic determinants among computed tomography (CT), histopathologic, and clinical features of TET.
  
  
  METHODS
  Two radiologists reviewed retrospectively CT findings of 437 patients (male 242, female 195; mean age, 51 years) with TET. With medical record review, surgico-histopathologic results were subcategorized into Masaoka-Koga stages I through IV and World Health Organization histopathologic classifications A-B1, B2-B3, and carcinoma. Overall survival and progression-free survival were analyzed. Clinical, histopathologic, and CT features were correlated from each other.
  
  
  RESULTS
  In all, 437 tumors were in Masaoka-Koga stage I (n = 147, 33.6%), stage II (n = 121, 27.7%), stage III (n = 76, 17.4%), or stage IV (n = 93, 21.3%); A and B1 (n = 114, 26.1%) and B2 and B3 TET (n = 223, 51.0%); and thymic carcinoma (n = 100, 22.9%). In multivariable analyses, age, Masaoka-Koga stage IV, thymic carcinoma, and CT stages III and IV were significantly correlated with overall survival (p < 0.05), whereas adjuvant treatment, Masaoka-Koga stages III and IV, World Health Organization B2 and B3, thymic carcinoma, R2 resection, CT size, and CT stage IV were significantly associated with progression-free survival (p < 0.05). Computed tomography stages showed moderate association with Masaoka-Koga stages (K = 0.621).
  
  
  CONCLUSIONS
  For TET, CT staging is effective in distinguishing both overall survival and progression-free survival, and patients with Masaoka-Koga stage IV or thymic carcinoma or CT stage IV have the worst prognosis.
authors.affiliation: Department of Radiology, Kangbuk Samsung Hospital, Seoul, Korea.
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Moon
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: kyungs.lee@samsung.com.
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Myung-Hee
authors.initials: MH
authors.lastname: Shin
authors.affiliation: Biostatistics Unit, Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea.
authors.forename: Seonwoo
authors.initials: S
authors.lastname: Kim
authors.affiliation: Biostatistics Unit, Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea.
authors.forename: Sook Young
authors.initials: SY
authors.lastname: Woo
authors.affiliation: Department of Radiology, Pusan National University Hospital, Busan, Korea.
authors.forename: Geewon
authors.initials: G
authors.lastname: Lee
authors.affiliation: Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Joungho
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Young Mog
authors.initials: YM
authors.lastname: Shim
authors.affiliation: Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013953:Thymus Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult