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J Thorac Cardiovasc Surg. 2015 Jan;149(1):95-100, 101.e1-2. doi: 10.1016/j.jtcvs.2014.09.124. Epub 2014 Oct 5.

Thymic carcinoma outcomes and prognosis: results of an international analysis.

Author information

1
Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
2
Department of Biostatistics, Yale University School of Medicine, New Haven, Conn; Medical Oncology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn.
3
Department of Thoracic Surgery, Yale University School of Medicine, New Haven, Conn.
4
Department of Thoracic Surgery, School of Medicine, University of Torino, Turin, Italy.
5
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.
6
Department of Biostatistics, Yale University School of Medicine, New Haven, Conn.
7
Division of Thoracic Surgery, Cardiac and Thoracic Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
8
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: rimnera@mskcc.org.

Erratum in

  • J Thorac Cardiovasc Surg. 2016 Apr;151(4):1220.

Abstract

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.

Comment in

PMID:
25524678
DOI:
10.1016/j.jtcvs.2014.09.124
[Indexed for MEDLINE]
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