Comparison of patterns of relapse in thymic carcinoma and thymoma Journal Article


Authors: Huang, J.; Rizk, N. P.; Travis, W. D.; Riely, G. J.; Park, B. J.; Bains, M. S.; Dycoco, J.; Flores, R. M.; Downey, R. J.; Rusch, V. W.
Article Title: Comparison of patterns of relapse in thymic carcinoma and thymoma
Abstract: Objective: Thymic carcinomas are considered to be more aggressive than thymomas and carry a worse prognosis. We reviewed our recent experience with the surgical management of thymic tumors and compared the outcomes and patterns of relapse between patients with thymic carcinoma and those with thymoma. Methods: We performed a single-institution retrospective cohort study. Data included patient demographics, stage, treatment, pathologic findings, and postoperative outcomes. Results: During the period 1995-2006, 120 patients with thymic tumors underwent surgical intervention, including 23 patients with thymic carcinoma and 97 patients with thymoma, as classified according to the World Health Organization 2004 histologic classification. The overall 5-year survival was significantly different between patients with thymic carcinoma and those with thymoma (thymic carcinoma, 53%; thymoma, 89%; P = .01). Data on relapse were available for 112 patients. The progression-free 5-year survival was also significantly different between patients with thymic carcinoma and those with thymoma (thymic carcinoma, 36%; thymoma, 75%; P < .01). Using multivariate analysis, thymic carcinoma and incomplete resection were found to be independent predictors of progression-free survival. Relapses in patients with thymic carcinoma tended to occur earlier, and occurred significantly more frequently at distant sites than in patients with thymoma (60% vs 13%, P = .01). Conclusions: Patterns of relapse differ significantly between patients with thymic carcinoma and those with thymoma, with lower progression-free survival, earlier onset, and more distant relapses in patients with thymic carcinoma. Given the greater propensity for distant failures, the inclusion of systemic therapy in the treatment of thymic carcinoma might take on greater importance. Despite significantly higher rates of distant relapse, good overall survival in patients with thymic carcinoma can be achieved. © 2009 The American Association for Thoracic Surgery.
Keywords: adult; cancer survival; controlled study; disease-free survival; middle aged; cancer surgery; survival rate; major clinical study; overall survival; disease course; cisplatin; doxorubicin; paclitaxel; cancer patient; postoperative care; cancer staging; demography; carboplatin; progression free survival; neoplasm recurrence, local; etoposide; cohort analysis; cyclophosphamide; retrospective study; docetaxel; survival time; carcinoma; predictor variable; cancer relapse; world health organization; cancer classification; thymoma; thymus neoplasms; thymus cancer
Journal Title: Journal of Thoracic and Cardiovascular Surgery
Volume: 138
Issue: 1
ISSN: 0022-5223
Publisher: Mosby Elsevier  
Date Published: 2009-07-01
Start Page: 26
End Page: 31
Language: English
DOI: 10.1016/j.jtcvs.2009.03.033
PUBMED: 19577051
PROVIDER: scopus
PMCID: PMC4151511
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: JTCSA" - "Source: Scopus"
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MSK Authors
  1. Valerie W Rusch
    865 Rusch
  2. Nabil Rizk
    139 Rizk
  3. James Huang
    214 Huang
  4. Raja Flores
    108 Flores
  5. William D Travis
    743 Travis
  6. Gregory J Riely
    601 Riely
  7. Bernard J Park
    263 Park
  8. Robert J Downey
    254 Downey
  9. Joseph Dycoco
    46 Dycoco
  10. Manjit S Bains
    338 Bains