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. 2014 Dec;9(12):1810-5.
doi: 10.1097/JTO.0000000000000363.

Clinical characteristics and outcomes for patients with thymic carcinoma: evaluation of Masaoka staging

Anya M Litvak  1 , Kaitlin Woo, Sara Hayes, James Huang, Andreas Rimner, Camelia S Sima, Andre L Moreira, Maria Tsukazan, Gregory J Riely
Affiliations

Clinical characteristics and outcomes for patients with thymic carcinoma: evaluation of Masaoka staging

Anya M Litvak et al. J Thorac Oncol. 2014 Dec.

Abstract

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.

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Figures

Figure 1
Figure 1
Overall Survival Based on Stage at Diagnosis
Figure 2
Figure 2
Overall Survival Based on Type of Resection
Figure 3
Figure 3
Overall Survival for Patients with Stage IVb Disease Based on Metastatic Site
Figure 4
Figure 4
Recurrence-Free Survival Based on Stage
See this image and copyright information in PMC

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