Multimodality treatment for advanced thymic carcinoma: outcomes of induction therapy followed by surgical resection in 16 cases at a single institution

• Published in: General thoracic and cardiovascular surgery 2015-03, Vol.63 (3), p.159-163
• Main Authors: Shintani, Yasushi, Inoue, Masayoshi, Kawamura, Tomohiro, Funaki, Soichiro, Minami, Masato, Okumura, Meinoshin
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cancer; Carcinoma, Neuroendocrine - drug therapy; Carcinoma, Neuroendocrine - pathology; Carcinoma, Neuroendocrine - surgery; Carcinoma, Neuroendocrine - therapy; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Carcinoma, Squamous Cell - therapy; Cardiac Surgery; Cardiology; Chemotherapy; Clinical outcomes; Combined Modality Therapy; Coronary vessels; Disease; Female; Humans; Induction therapy; Lymphatic system; Magnetic resonance imaging; Male; Medical prognosis; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Neoadjuvant Therapy - methods; Oncology; Original Article; Patients; Pericardium; Pulmonary arteries; Radiation therapy; Remission (Medicine); Surgical Oncology; Survival Rate; Thoracic Surgery; Thymoma - drug therapy; Thymoma - pathology; Thymoma - surgery; Thymoma - therapy; Thymus Neoplasms - drug therapy; Thymus Neoplasms - pathology; Thymus Neoplasms - surgery; Thymus Neoplasms - therapy; Tomography; Treatment Outcome; Tumors; Veins & arteries
• ISSN: 1863-6705; 1863-6713
• DOI: 10.1007/s11748-014-0486-7

Objective We reviewed our institutional experience with cases of multimodality treatment for advanced thymic carcinoma to determine patient outcomes and prognostic indicators. Methods Between 1998 and 2014, 16 patients with a Masaoka stage III or IV thymic carcinoma underwent surgical resection after induction therapy at Osaka University Hospital. These were considered to have great vessel invasion or metastasis to the mediastinal or intrathoracic lymph nodes based on the preoperative workup findings, and received induction therapy. Results Complete tumor resection was achieved in 11 (69 %) after the induction therapy. Pathological findings revealed that 10 patients had Masaoka stage III disease, 1 had IVa, and 5 had IVb. The histological diagnosis was squamous cell carcinoma in 13, neuroendocrine carcinoma in 2, and undifferentiated carcinoma in 1. The 5-year survival rate for all patients was 71 %. Survival was significantly better in patients who underwent a complete resection (R0 disease) as compared to those with incompletely resected tumors (R1 or R2 disease). Conclusions Multimodality treatment offers encouraging results and complete resection provides high survival rate for patients with advanced thymic carcinoma.