Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
권호 표지
DOI QR코드

DOI QR Code

Invasion of the great vessels or atrium predicts worse prognosis in thymic carcinoma

  • Eom, Keun-Yong (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Kim, Hak Jae (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Wu, Hong-Gyun (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Kim, Young Tae (Department of Thoracic Surgery, Seoul National University College of Medicine) ;
  • Heo, Dae Seog (Cancer Research Institute, Seoul National University College of Medicine) ;
  • Kim, Young Whan (Department of Internal Medicine, Seoul National University College of Medicine)
  • Received : 2013.05.20
  • Accepted : 2013.07.31
  • Published : 2013.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: We evaluated treatment outcomes of thymic carcinomas to determine prognostic factors for survival. Materials and Methods: Between May 1988 and May 2009, 41 patients had pathologic diagnosis of thymic carcinoma in Seoul National University Hospital, Seoul, Korea. Of these, 40 patients were followed up to 188 months after treatment. The mean age of all patients was 58.3 years and male to female ratio was 23 to 17. Results: Among 30 patients who underwent surgical resection, 26 achieved R0 resection and postoperative radiotherapy (PORT) was performed in 22 patients (73%). Various chemotherapeutic regimens were given with local treatment modalities, surgery and/or radiotherapy, in 12 patients. The 5-year locoregional control (LRC), distant metastasis-free survival, progression-free survival (PFS), and overall survival were 79.4%, 53.0%, 42.6%, and 63.6%, respectively. Patients with Masaoka stage I or II showed excellent prognosis of 5-year PFS around 90%. In advanced stages, invasion of the great vessels or atrium by thymic carcinomas was negative prognostic factor for PFS in univariate analysis. Lymph node involvement was statistically significant factor for LRC and PFS. Local or regional recurrence was infrequent after surgical resection followed by PORT, while distant metastasis was the major component of treatment failure. Conclusion: Complete resection followed by PORT provided remarkable local control without severe acute toxicities in patients with stage II and favorable stage III thymic carcinoma. Invasion of the great vessels or atrium was statistically significant prognostic factor for PFS.

Keywords

References

  1. Travis WD, Brambilla E, Muller-Hermelink HK, Harris CC. Tumours of the lung, pleura, thymus and heart. Lyon: IARC Press; 2004.
  2. Masaoka A. Staging system of thymoma. J Thorac Oncol 2010;5(10 Suppl 4):S304-12. https://doi.org/10.1097/JTO.0b013e3181f20c05
  3. Tseng YL, Wang ST, Wu MH, Lin MY, Lai WW, Cheng FF. Thymic carcinoma: involvement of great vessels indicates poor prognosis. Ann Thorac Surg 2003;76:1041-5. https://doi.org/10.1016/S0003-4975(03)00831-2
  4. Huang J, Rizk NP, Travis WD, et al. Comparison of patterns of relapse in thymic carcinoma and thymoma. J Thorac Cardiovasc Surg 2009;138:26-31. https://doi.org/10.1016/j.jtcvs.2009.03.033
  5. Blumberg D, Burt ME, Bains MS, et al. Thymic carcinoma: current staging does not predict prognosis. J Thorac Cardiovasc Surg 1998;115:303-8. https://doi.org/10.1016/S0022-5223(98)70273-9
  6. Mayer R, Beham-Schmid C, Groell R, et al. Radiotherapy for invasive thymoma and thymic carcinoma. Strahlenther Onkol 1999;175:271-8. https://doi.org/10.1007/BF02743578
  7. Kondo K, Monden Y. Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan. Ann Thorac Surg 2003;76:878-84. https://doi.org/10.1016/S0003-4975(03)00555-1
  8. Strobel P, Bauer A, Puppe B, et al. Tumor recurrence and survival in patients treated for thymomas and thymic squamous cell carcinomas: a retrospective analysis. J Clin Oncol 2004;22:1501-9. https://doi.org/10.1200/JCO.2004.10.113
  9. Bedini AV, Andreani SM, Tavecchio L, et al. Proposal of a novel system for the staging of thymic epithelial tumors. Ann Thorac Surg 2005;80:1994-2000. https://doi.org/10.1016/j.athoracsur.2005.07.019
  10. Chang HK, Wang CH, Liaw CC, et al. Prognosis of thymic carcinoma: analysis of 16 cases. J Formos Med Assoc 1992;91:764-9.
  11. Hsu CP, Chen CY, Chen CL, et al. Thymic carcinoma: ten years' experience in twenty patients. J Thorac Cardiovasc Surg 1994;107:615-20.
  12. Yano T, Hara N, Ichinose Y, Asoh H, Yokoyama H, Ohta M. Treatment and prognosis of primary thymic carcinoma. J Surg Oncol 1993;52:255-8. https://doi.org/10.1002/jso.2930520412
  13. Ogawa K, Toita T, Uno T, et al. Treatment and prognosis of thymic carcinoma: a retrospective analysis of 40 cases. Cancer 2002;94:3115-9. https://doi.org/10.1002/cncr.10588
  14. Nakamura Y, Kunitoh H, Kubota K, et al. Platinum-based chemotherapy with or without thoracic radiation therapy in patients with unresectable thymic carcinoma. Jpn J Clin Oncol 2000;30:385-8. https://doi.org/10.1093/jjco/hyd108
  15. Lucchi M, Mussi A, Ambrogi M, et al. Thymic carcinoma: a report of 13 cases. Eur J Surg Oncol 2001;27:636-40. https://doi.org/10.1053/ejso.2001.1197
  16. Park S, Ahn MJ, Ahn JS, et al. A prospective phase II trial of induction chemotherapy with docetaxel/cisplatin for Masaoka stage III/IV thymic epithelial tumors. J Thorac Oncol 2013;8:959-66. https://doi.org/10.1097/JTO.0b013e318292c41e

Cited by

  1. Radiotherapy for Thymic Carcinoma: Adjuvant, Inductive, and Definitive vol.3, pp.None, 2013, https://doi.org/10.3389/fonc.2013.00330