A Single-Center Analysis of the Treatment and Prognosis of Patients With Thymic Carcinoma

The low incidence of thymic carcinoma has precluded the development of randomized clinical trials, and present knowledge is based on small retrospective studies. We performed this single-center retrospective analysis to evaluate the clinical characteristics, treatments, and prognosis in patients with pathologically confirmed thymic carcinoma.

Data regarding clinicopathologic characteristics, treatment protocols, toxicities, and survival were collected from 135 patients who attended our institution between January 1980 and January 2010. Survival was assessed using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the log-rank test and Cox proportional hazards model.

The 135 patients (88 men) were with a median age of 48 years, and 123 patients were diagnosed with Masaoka stage III to IV disease. R0 resection was performed in 35 patients. Treatment comprised radiotherapy in 121 patients and chemotherapy in 60. The median follow-up time was 12.5 years. At 5 and 10 years, local-regional relapse free survivals were 81.4% and 54.4%, overall survivals were 42.2% and 15.4%, progression-free survivals were 29.7% and 8.0%, and distant metastasis-free survivals were 35.9% and 25.6%, respectively. R0 resection was the only independent prognosticator of overall survival, progression-free survival, and distant metastasis-free survival in univariate and multivariate analyses.

Thymic carcinoma was frequently diagnosed at Masaoka stage III to IV with a poor prognosis. Surgical resection is still the predominant treatment. Radiotherapy may increase local-regional relapse free survival with mild toxicities in advanced-stage patients.