TY - JOUR
T1 - Thymic carcinoma
T2 - A cohort study of patients from the European society of thoracic surgeons database
AU - European Society of Thoracic Surgeons Thymic Working Group
AU - Ruffini, Enrico
AU - Detterbeck, Frank
AU - van Raemdonck, Dirk
AU - Rocco, Gaetano
AU - Thomas, Pascal
AU - Weder, Walter
AU - Brunelli, Alessandro
AU - Guerrera, Francesco
AU - Keshavjee, Shaf
AU - Altorki, Nasser
AU - Schützner, Jan
AU - Arame, Alex
AU - Spaggiari, Lorenzo
AU - Lim, Eric
AU - Toker, Alper
AU - Venuta, Federico
AU - Alkattan, Khaled
AU - Refai, Majed
AU - Casadio, Caterina
AU - Carbognani, Paolo
AU - Cerfolio, Robert
AU - Donati, Giovanni
AU - Foroulis, Christophoros N.
AU - Gebitekin, Cengiz
AU - de Antonio, David Gomez
AU - Kernstine, Kemp H.
AU - Moser, Bernhard
AU - Lequaglie, Cosimo
AU - Liberman, Moishe
AU - Nicholson, Andrew G.
AU - Lang-Lazdunski, Loic
AU - Mancuso, Maurizio
AU - Nosotti, Mario
AU - Novoa, Nuria M.
AU - Brioude, Geoffrey
AU - Filosso, Pier Luigi
AU - Solidoro, Paolo
AU - Saita, Salvatore
AU - Scarci, Marco
AU - Terzi, Alberto
AU - van Veer, Hans
AU - Anile, Marco
AU - Rendina, Erino
AU - Voltolini, Luca
AU - Zurek, Wojciech
N1 - Publisher Copyright:
© 2014 by the International Association for the Study of Lung Cancer.
PY - 2014
Y1 - 2014
N2 - Introduction: Thymic carcinoma is a rare and aggressive thymic neoplasm. The European Society of Thoracic Surgeons developed a retrospective database collecting patients undergoing resection for thymic tumors from 1990 to 2010. Methods: Of 2265 patients with thymic tumors, there were 229 thymic carcinomas. Clinicopathological characteristics were analyzed including age, associated paraneoplastic diseases, stage (Masaoka-Koga), World Health Organization histologic subtypes, type of resection (total/ subtotal/biopsy/no resection), tumor size, pre/postoperative treatments, and recurrence. Outcome measures included overall survival (OS), freedom from recurrence, and cumulative incidence of recurrence. Results: A complete resection was achieved in 140 patients (69%). Recurrence occurred in 54 patients (28%). Five- and 10-year OS rates were 0.61 and 0.37. Five- and 10-year freedom from recurrence rates were 0.60 and 0.43. Cumulative incidence of recurrence was 0.21 (3 yr), 0.27 (5 yr), and 0.32 (10 yr). Survival was better after surgical resection versus biopsy/no resection (p < 0.001), after complete resection versus subtotal resection (p < 0.001), and when using Masaoka-Koga system (stages I-II versus III versus IV) (p < 0.001). The use of multidisciplinary treatments resulted in a survival advantage which was significant in the surgery + radiotherapy group (p = 0.02). Incomplete resection (p < 0.0001) and advanced stage (Masaoka-Koga III-IV) (p = 0.02) had a negative impact on OS at multivariable analysis. Administration of adjuvant radiotherapy was beneficial in increasing OS (p = 0.02). Conclusions: The results of our study indicate that patients with thymic carcinoma should undertake surgical resection whenever possible; a complete resection and early Masaoka-Koga stage are independent predictors of improved survival; our results also suggest that postoperative radiotherapy is beneficial in improving survival.
AB - Introduction: Thymic carcinoma is a rare and aggressive thymic neoplasm. The European Society of Thoracic Surgeons developed a retrospective database collecting patients undergoing resection for thymic tumors from 1990 to 2010. Methods: Of 2265 patients with thymic tumors, there were 229 thymic carcinomas. Clinicopathological characteristics were analyzed including age, associated paraneoplastic diseases, stage (Masaoka-Koga), World Health Organization histologic subtypes, type of resection (total/ subtotal/biopsy/no resection), tumor size, pre/postoperative treatments, and recurrence. Outcome measures included overall survival (OS), freedom from recurrence, and cumulative incidence of recurrence. Results: A complete resection was achieved in 140 patients (69%). Recurrence occurred in 54 patients (28%). Five- and 10-year OS rates were 0.61 and 0.37. Five- and 10-year freedom from recurrence rates were 0.60 and 0.43. Cumulative incidence of recurrence was 0.21 (3 yr), 0.27 (5 yr), and 0.32 (10 yr). Survival was better after surgical resection versus biopsy/no resection (p < 0.001), after complete resection versus subtotal resection (p < 0.001), and when using Masaoka-Koga system (stages I-II versus III versus IV) (p < 0.001). The use of multidisciplinary treatments resulted in a survival advantage which was significant in the surgery + radiotherapy group (p = 0.02). Incomplete resection (p < 0.0001) and advanced stage (Masaoka-Koga III-IV) (p = 0.02) had a negative impact on OS at multivariable analysis. Administration of adjuvant radiotherapy was beneficial in increasing OS (p = 0.02). Conclusions: The results of our study indicate that patients with thymic carcinoma should undertake surgical resection whenever possible; a complete resection and early Masaoka-Koga stage are independent predictors of improved survival; our results also suggest that postoperative radiotherapy is beneficial in improving survival.
KW - Prognostic factors
KW - Staging
KW - Surgery
KW - Thymic carcinoma
KW - Thymic tumors
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U2 - 10.1097/JTO.0000000000000128
DO - 10.1097/JTO.0000000000000128
M3 - Article
C2 - 24736078
AN - SCOPUS:84908450550
SN - 1556-0864
VL - 9
SP - 541
EP - 548
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 4
ER -