Thymic carcinoma

Outcomes after surgical resection

Ikenna C. Okereke, Kenneth Kesler, Richard K. Freeman, Karen Rieger, Thomas Birdas, Anthony J. Ascioti, Sunil Badve, Robert Nelson, Patrick Loehrer

Research output: Contribution to journalArticle

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Abstract

Background: Thymic carcinoma is a rare malignancy with little information regarding outcomes after therapy with curative intent. We undertook a retrospective analysis of all patients who underwent resection of thymic carcinoma at 2 hospitals. Methods: From 1990 to 2011, 16 patients (9 men, 7 women) underwent surgical resection of thymic carcinoma at a mean age of 52 years. Patient demographics, extent of surgical resection, and outcomes were compiled. Results: The distribution of Masaoka stages at presentation was I in 3 (19%), II in 4 (25%), III in 8 (50%), and IV in 1 (6%). Neoadjuvant chemotherapy was administered to 6 patients (38%) whose tumors were deemed to be more locally invasive. Surgical resection included en bloc extrapleural pneumonectomy in 1, lobectomy in 2, and superior vena cava resection and reconstruction in 4. There were no perioperative deaths. Complete resection was achieved in 14 (88%), and of these patients, only 1 experienced local recurrence. At last follow-up, 10 patients were alive and well, 1 patient was alive with disease, and 5 patients had died. Mean survival was 4.2 years. Conclusions: Although considered to have greater malignant potential, long-term survival can be achieved in patients with thymic carcinoma who are amenable to surgical therapy. With increased use of computed tomography imaging, patients with early-stage disease are being identified more frequently, and complete surgical resection appears to have favorable cure rates in these patients. Select patients with locally advanced disease can experience long-term survival with a multimodality approach.

Original languageEnglish
Pages (from-to)1668-1673
Number of pages6
JournalAnnals of Thoracic Surgery
Volume93
Issue number5
DOIs
StatePublished - May 2012

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Thymoma
Survival
Superior Vena Cava
Pneumonectomy
Neoplasms
Tomography
Demography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Thymic carcinoma : Outcomes after surgical resection. / Okereke, Ikenna C.; Kesler, Kenneth; Freeman, Richard K.; Rieger, Karen; Birdas, Thomas; Ascioti, Anthony J.; Badve, Sunil; Nelson, Robert; Loehrer, Patrick.

In: Annals of Thoracic Surgery, Vol. 93, No. 5, 05.2012, p. 1668-1673.

Research output: Contribution to journalArticle

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abstract = "Background: Thymic carcinoma is a rare malignancy with little information regarding outcomes after therapy with curative intent. We undertook a retrospective analysis of all patients who underwent resection of thymic carcinoma at 2 hospitals. Methods: From 1990 to 2011, 16 patients (9 men, 7 women) underwent surgical resection of thymic carcinoma at a mean age of 52 years. Patient demographics, extent of surgical resection, and outcomes were compiled. Results: The distribution of Masaoka stages at presentation was I in 3 (19{\%}), II in 4 (25{\%}), III in 8 (50{\%}), and IV in 1 (6{\%}). Neoadjuvant chemotherapy was administered to 6 patients (38{\%}) whose tumors were deemed to be more locally invasive. Surgical resection included en bloc extrapleural pneumonectomy in 1, lobectomy in 2, and superior vena cava resection and reconstruction in 4. There were no perioperative deaths. Complete resection was achieved in 14 (88{\%}), and of these patients, only 1 experienced local recurrence. At last follow-up, 10 patients were alive and well, 1 patient was alive with disease, and 5 patients had died. Mean survival was 4.2 years. Conclusions: Although considered to have greater malignant potential, long-term survival can be achieved in patients with thymic carcinoma who are amenable to surgical therapy. With increased use of computed tomography imaging, patients with early-stage disease are being identified more frequently, and complete surgical resection appears to have favorable cure rates in these patients. Select patients with locally advanced disease can experience long-term survival with a multimodality approach.",
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AU - Okereke, Ikenna C.

AU - Kesler, Kenneth

AU - Freeman, Richard K.

AU - Rieger, Karen

AU - Birdas, Thomas

AU - Ascioti, Anthony J.

AU - Badve, Sunil

AU - Nelson, Robert

AU - Loehrer, Patrick

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