• Usman Ahmad, Xiaopan Yao, Frank Detterbeck, James Huang, Alberto Antonicelli, Pier Luigi Filosso, Enrico Ruffini, William Travis, David R Jones, Yilei Zhan, Marco Lucchi, and Andreas Rimner.
• Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
• J. Thorac. Cardiovasc. Surg.. 2015 Jan 1;149(1):95-100, 101.e1-2.

ObjectivesThe objectives of this collaborative study were to characterize patients with thymic carcinoma, their treatment patterns, and association with overall survival (OS) and recurrence-free survival (RFS).MethodsClinical, pathologic, treatment, and follow-up information were analyzed. OS and RFS were the primary outcome measures.ResultsIn 1042 cases of thymic carcinoma, 42 (5%) patients had pathologic Masaoka stage I, 138 (17%) had stage II, 370 (45%) had stage III, and 274 (33%) had stage IV disease. Overall, 166 patients (22%) underwent induction chemotherapy and 48 (6%) had preoperative radiation therapy. An R0 resection was performed in 447 cases (61%), R1 in 102 cases (14%), and R2 in 184 cases (25%). Squamous cell carcinoma was the predominant histologic subtype (n = 560; 79%). Adjuvant chemotherapy was administered to 237 (31%) patients, and 449 (60%) received adjuvant radiation therapy. The median OS was 6.6 years (95% confidence interval [CI], 5.8-8.3) and the cumulative incidence of recurrence at 5 years was 35% (95% CI, 30%-40%). In univariate analysis, early Masaoka stage, R0 resection, chemotherapy, and radiation therapy were associated with OS. Early Masaoka stage and R0 resection were also associated with RFS. On multivariable analysis, R0 resection and radiation therapy were associated with prolonged OS. Radiation therapy and male gender were associated with prolonged RFS.ConclusionsR0 resection and radiation therapy are associated with improved OS, whereas radiation therapy and male gender are associated with longer RFS.Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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