With ethics approval, data collected included patient characteristics, histologic type (World Health Organization [WHO] criteria), staging (Masaoka system), paraneoplastic syndromes, treatment details, and outcomes. The primary analysis is descriptive.
Thymic epithelial neoplasms were identified in 76 patients: 46% women with a median age 60聽years (range, 25-89 years), 93% with Eastern Cooperative Oncology Group performance status of 0 to 1. Myasthenia gravis was present in 21%. The distribution by WHO histologic classification was A, 15%; AB, 30%; B1, 16%; B2, 13%; B3, 17%; C, 7%; neuroendocrine thymic tumor (NETT), 1%; and unclassified, 1%. Of 64 patients who underwent operation, 53 underwent R0 resection. Eleven surgical patients received chemotherapy (induction, n聽= 6; adjuvant, n聽= 4; both, n聽= 1) and 27 received radiotherapy (induction, n聽= 2; adjuvant, n聽= 25). Twelve patients were not considered for surgery, and 3 patients received no therapy at all. Chemotherapy was received at some point in the聽disease course in 14 patients. Common first-line regimens were platinum/etoposide (n聽= 8), carboplatin/paclitaxel (n聽= 3), and CAP (cyclophosphamide, doxorubicin [Adriamycin], cisplatin [n聽= 2]). The first-line response rate (Response Evaluation in Solid Tumors [RECIST]) was 55%. After a median follow-up of 45 months, 59 (78%) patients remain alive. Thymoma was associated with superior overall survival compared with thymic carcinoma (P聽< .0001).
Although surgical resection is the mainstay of treatment for thymic epithelial neoplasms, it remains clear that these are chemosensitive diseases.