Outcome of surgically resected thymic carcinoma: A multicenter experience

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• 作者：Pier Luigi Filosso ; Francesco Guerrera ; Angelo Erino Rendina ; Giulia Bora ; Enrico Ruffini ; Domenico Novero ; Luigi Ruco ; Domenico Vitolo ; Marco Anile ; Mohsen Ibrahim ; Caterina Casadio ; Ottavio Rena ; Alberto Terzi ; Paraskevas Lyberis ; Alberto Oliaro ; Federico Venuta
• 关键词：Thymic carcinoma ; Thymus ; Masaoka staging system ; Myasthenia Gravis ; Surgery ; Outcome
• 刊名：Lung Cancer
• 出版年：February, 2014
• 年：2014
• 卷：83
• 期：2
• 页码：205-210
• 全文大小：739 K

文摘

Objective

Thymic carcinoma (TC) is a rare and invasive mediastinal tumor, with poor prognosis. Most of the previous published papers are single-institution based, reporting small series of patient, sometimes including palliative resection. This study collected patients with TC treated in 5 high-volume Italian Thoracic Surgery Institutions.

Methods

A multicenter retrospective study of patients operated for TC between 2000 and 2011 was conducted. Exclusion criteria were: Neuroendocrine thymic neoplasms, debulking/palliative resection and tumor biopsy. Cause specific survival (CSS) was the primary endpoint.

Results

Four hundred and seventy-eight patients underwent surgery for thymic malignancies: 40 of them (8.4%) had TC. Eleven (27.5%) received induction chemotherapy because of their radiological invasiveness. A complete resection (R0) was achieved in 36 (90%; 9/11 submitted to induction chemotherapy). Adjuvant radio/chemotherapy was offered to 37 patients, according to the type of surgical resection and tumor invasiveness. Three, 5 and 10-year survival rates were 79%, 75% and 58%. Recurrences developed in 10 patients. R0 resection (p < 0.0003) and absence of tumor recurrences (p = 0.03) resulted significant prognostic factors at univariate analysis. Independent CSS predictor was the achievement of a complete resection (p < 0.05).

Conclusions

TC is a rare and invasive mediastinal tumor. A multimodal approach is indicated especially in TC invasive forms. The achievement of a complete surgical resection is fundamental to improve survival.