Results Of A Surgical Resection For Patients With Thymic Carcinoma And Multimodality Treatments Of Advanced Stage Thymic Carcinomas

Objective To investigate the clinical features of patients with resection of thymic carcinoma and evaluate the results of multidisciplinary approaches in multimodality treatment of advanced stage (III and IV) thymic tumors.Materials and methods We retrospectively analyzed135patients with pathologically confirmed thymic carcinoma treated at the Cancer Hospital, Chinese Academy of Medical Science, including87males and48females.Squamous cell carcinoma:78patients; small cell carcinoma:11patients; Lymphoepitheliomalike carcinoma13patients adenocarcinoma3patients; Poorly differentiated carcinoma30patients. The clinical stage was determined according to Masaoka’s classification:stage Ⅰ12, stageⅡ14, stageⅢ60, stage IV49,of the93surgery patients,50patients were treated by total resection of the tumor,26partial resection and17exploratory thoracotomy. In97cases of advanced Stage Thymic Carcinomas (Ⅲ+Ⅳ):Of the71surgery patients,29patients were treated by total resection of the tumor,25partial resection and17exploratory thoracotomy,10patients underwent surgery only.59surgery patients received radiation therapy,31surgery patients received chemotherapy, Survival rate was calculated and the survival curve plotted by Kaplan-Meier method, prognostic factors were evaluated by the log-rank and Cox multivariate analysis model. The median follow-up time was132months.Results The overall3-,5-,10-year survival rate was59.3%,48.2%and29.3%, respectively, with median survival time of35.1months. The5-year survival rate was58.3%,,51.9%,61.7%and31.9%, in stage Ⅰ,stage Ⅱ,stage Ⅲ, and stage Ⅳ respectively(P=0.012). Single factor analysis shows Masaoka stage, surgical treatment, operation method, pathological type to be statistically significant independent predictors of survival. Multivariate analysis showed only operation method to be statistically significant independent predictors of survival. In97cases of advanced Stage Thymic Carcinomas (Ⅲ+Ⅳ), Single factor analysis shows surgical treatment to be statistically significant independent predictors of survival. Of the71surgery patients of advanced Stage thymic Carcinomas, Single factor analysis and Multivariate analysis shows surgical method and surgery combination with radiation therapy to be statistically significant independent predictors of survival.Conclusions The prognosis of thymic carcinoma is poor. Masaoka staging, type of tumor resection, histological WHO classification and surgery are significant prognosis factors. This result shows that surgery plus postoperative radiotherapy is a model and reasonable treatment for thymic carcinoma.