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2014 ; 9
(12
): 1810-5
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Clinical characteristics and outcomes for patients with thymic carcinoma:
evaluation of Masaoka staging
#MMPMID25393794
Litvak AM
; Woo K
; Hayes S
; Huang J
; Rimner A
; Sima CS
; Moreira AL
; Tsukazan M
; Riely GJ
J Thorac Oncol
2014[Dec]; 9
(12
): 1810-5
PMID25393794
show ga
BACKGROUND: Thymic carcinomas are rare cancers with limited data regarding
outcomes, particularly for those patients with advanced disease. METHODS: We
identified patients with thymic carcinomas diagnosed between 1993 and 2012.
Patient characteristics, recurrence-free survival (RFS), and overall survival
(OS) were analyzed. RESULTS: One hundred twenty-one patients with thymic
carcinomas were identified. Higher Masaoka stage was associated with worse OS and
RFS (5-year OS of 100%, 81%, 51%, 24%, and 17% for stage I, II, III, IVa, and IVb
respectively, p < 0.001 and 5-year RFS of 80%, 28%, and 7% for stage I/II, III,
and IV respectively, p < 0.001). Patients with stage IVb lymph node (LN) only
disease had a better 5-year OS as compared with patients with distant metastasis
(24% versus 7%, p = 0.025). Of the 61 patients with stage IVb disease, 22 of 29
patients (76%) with LN-only disease underwent curative intent resection versus 3
of 32 patients (9%) with distant metastasis. Twenty-two patients with LN
involvement were treated with multimodality therapy. Three (14%) remain free of
disease with long-term follow-up (range, 3.4+ years- to 6.8+ years). CONCLUSIONS:
We describe the clinical features of a large series of patients with thymic
carcinoma in North America. The Masaoka staging system effectively prognosticated
OS and RFS. Patients with stage IVb LN-only disease had significantly better OS
as compared with patients with distant metastasis with a subset of patients
sustaining long-term RFS with multimodality therapy. If validated, these data
would support a revised staging system with subclassification of stage IVb
disease into two groups.