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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Thorac+Oncol 2014 ; 9 (12): 1810-5 Nephropedia Template TP
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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 PMID25393794show 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-yr OS of 100%, 81%, 51%, 24%, and 17% for stage I, II, III, IVa and IVb respectively, p<0.001 and 5-yr 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 to patients with distant metastasis (24% vs. 7%, p=0.025). Of the 61 patients with stage IVb disease, 22/29 patients (76%) with LN-only disease underwent curative intent resection vs. 3/32 patients (9%) with distant metastasis. Twenty-two patients with LN involvement were treated with multi-modality 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 to patients with distant metastasis with a subset of patients sustaining long term RFS with multi-modality therapy. If validated, these data would support a revised staging system with sub-classification of stage IVb disease into two groups.