title: Adjuvant Therapy for Thymic Carcinoma--A Decade of Experience in a Taiwan National Teaching Hospital.
abstract: BACKGROUND
  Thymic carcinomas are rare tumors for which surgical resection is the first treatment of choice. The role of adjuvant treatment after surgery is unknown because of limited available data. The present study evaluated the efficacy of post-surgery adjuvant chemotherapy or radiotherapy in patients with thymic carcinoma.
  
  
  METHODS
  To evaluate the role of adjuvant therapy in patients with thymic carcinoma, we retrospectively reviewed the records of patients with thymic carcinoma who were diagnosed and treated between 2004 and 2014.
  
  
  RESULTS
  Among 78 patients with thymic carcinoma, 30 patients received surgical resection. Progression-free survival (PFS) and overall survival (OS) were significantly longer among these patients than among patients who received other treatments (PFS: 88.4 months vs 9.1 months, p<0.001; OS: 134.9 months vs 60.9 months; p = 0.003). Patients with stage III thymic carcinoma who received surgery had a longer OS than patients who did not receive surgery (70.1 months vs 23.9 months; p = 0.017, n = 11). Among 47 patients with stage IV carcinoma, 12 patients who received an extended thymothymectomy had a longer PFS than 35 patients who did not receive surgery (18.9 months vs 8.7 months; p = 0.029). Among 30 patients (with stage I- IV carcinoma) who received primary lesion surgery, 19 patients received an R0 resection and 9 patients of the 19 patients received adjuvant radiotherapy. These patients had longer PFS (50.3 months) than 2 patients who received adjuvant chemotherapy (5.9 months) or 4 patients who received concurrent chemoradiotherapy (7.5 months) after surgery (p = 0.003).
  
  
  CONCLUSIONS
  Surgical resection should be considered for patients with thymic carcinoma, even for patients with locally advanced or stage IV carcinoma. Adjuvant radiotherapy resulted in a better PFS after R0 resection.
authors.affiliation: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.
authors.forename: Yen-Han
authors.initials: YH
authors.lastname: Tseng
authors.affiliation: Department of Family Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei, Taiwan, Republic of China.
authors.forename: Yi-Hsuan
authors.initials: YH
authors.lastname: Lin
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.|Department of Surgery, Kaohsiung Veterans General Hospital, Pingtung Branch, Pingtung, Taiwan, Republic of China.
authors.forename: Yen-Chiang
authors.initials: YC
authors.lastname: Tseng
authors.affiliation: Sijhih Cathay General Hospital, New Taipei, Taiwan, Republic of China.
authors.forename: Yu-Chin
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Wen-Hu
authors.initials: WH
authors.lastname: Hsu
authors.affiliation: Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Sang-Hue
authors.initials: SH
authors.lastname: Yen
authors.affiliation: Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Whang-Peng
authors.affiliation: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.|Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Yuh-Min
authors.initials: YM
authors.lastname: Chen
mesh_terms: D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006784:Hospitals, Teaching; D006801:Humans; D009367:Neoplasm Staging; D011182:Postoperative Care; D016019:Survival Analysis; D013624:Taiwan; D013945:Thymoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery