General thoracic surgery
Thymic carcinoma outcomes and prognosis: Results of an international analysis

Read at the 94th Annual Meeting of The American Association for Thoracic Surgery, Toronto, Ontario, Canada, April 26-30, 2014.
https://doi.org/10.1016/j.jtcvs.2014.09.124Get rights and content
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Objectives

The objectives of this collaborative study were to characterize patients with thymic carcinoma, their treatment patterns, and association with overall survival (OS) and recurrence-free survival (RFS).

Methods

Clinical, pathologic, treatment, and follow-up information were analyzed. OS and RFS were the primary outcome measures.

Results

In 1042 cases of thymic carcinoma, 42 (5%) patients had pathologic Masaoka stage I, 138 (17%) had stage II, 370 (45%) had stage III, and 274 (33%) had stage IV disease. Overall, 166 patients (22%) underwent induction chemotherapy and 48 (6%) had preoperative radiation therapy. An R0 resection was performed in 447 cases (61%), R1 in 102 cases (14%), and R2 in 184 cases (25%). Squamous cell carcinoma was the predominant histologic subtype (n = 560; 79%). Adjuvant chemotherapy was administered to 237 (31%) patients, and 449 (60%) received adjuvant radiation therapy. The median OS was 6.6 years (95% confidence interval [CI], 5.8-8.3) and the cumulative incidence of recurrence at 5 years was 35% (95% CI, 30%-40%). In univariate analysis, early Masaoka stage, R0 resection, chemotherapy, and radiation therapy were associated with OS. Early Masaoka stage and R0 resection were also associated with RFS. On multivariable analysis, R0 resection and radiation therapy were associated with prolonged OS. Radiation therapy and male gender were associated with prolonged RFS.

Conclusions

R0 resection and radiation therapy are associated with improved OS, whereas radiation therapy and male gender are associated with longer RFS.

CTSNet classification

13

Abbreviations and Acronyms

CIR
cumulative incidence of recurrence
ESTS
European Society of Thoracic Surgeons
IASLC
International Association for the Study of Lung Cancer
ITMIG
International Thymic Malignancy Interest Group
OS
overall survival
RFS
recurrence-free survival
SEER
Surveillance, Epidemiology, and End Results

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Disclosures: Authors have nothing to disclose with regard to commercial support.