Usman Ahmad1, Xiaopan Yao2, Frank Detterbeck3, James Huang1, Alberto Antonicelli3, Pier Luigi Filosso4, Enrico Ruffini4, William Travis5, David R Jones1, Yilei Zhan6, Marco Lucchi7, Andreas Rimner8. 1. Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. 2. Department of Biostatistics, Yale University School of Medicine, New Haven, Conn; Medical Oncology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn. 3. Department of Thoracic Surgery, Yale University School of Medicine, New Haven, Conn. 4. Department of Thoracic Surgery, School of Medicine, University of Torino, Turin, Italy. 5. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY. 6. Department of Biostatistics, Yale University School of Medicine, New Haven, Conn. 7. Division of Thoracic Surgery, Cardiac and Thoracic Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. 8. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: rimnera@mskcc.org.
Abstract
OBJECTIVES: The 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). METHODS: Clinical, pathologic, treatment, and follow-up information were analyzed. OS and RFS were the primary outcome measures. RESULTS: In 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. CONCLUSIONS: R0 resection and radiation therapy are associated with improved OS, whereas radiation therapy and male gender are associated with longer RFS.
OBJECTIVES: The 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). METHODS: Clinical, pathologic, treatment, and follow-up information were analyzed. OS and RFS were the primary outcome measures. RESULTS: In 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. CONCLUSIONS: R0 resection and radiation therapy are associated with improved OS, whereas radiation therapy and male gender are associated with longer RFS.
Authors: Alexander Marx; John K C Chan; Jean-Michel Coindre; Frank Detterbeck; Nicolas Girard; Nancy L Harris; Elaine S Jaffe; Michael O Kurrer; Edith M Marom; Andre L Moreira; Kiyoshi Mukai; Attilio Orazi; Philipp Ströbel Journal: J Thorac Oncol Date: 2015-10 Impact factor: 15.609
Authors: Andreas Rimner; Xiaopan Yao; James Huang; Alberto Antonicelli; Usman Ahmad; Robert J Korst; Frank Detterbeck; Daniel R Gomez Journal: J Thorac Oncol Date: 2016-06-23 Impact factor: 15.609