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Ann Thorac Surg 2002;73:1076-1081
© 2002 The Society of Thoracic Surgeons

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Original article: general thoracic

Primary thymic carcinoma

^a Divisions of Thoracic Surgery, Taipei, Taiwan
^b Pathology, Taipei, Taiwan
^c Oncology, Mackay Memorial Hospital and Taipei Veterans General Hospital, Taipei, Taiwan
^d Divisions of Surgery, Taipei Medical University, Taipei, Taiwan
^e Yang-Ming University, Taipei, Taiwan

Accepted for publication December 4, 2001.

* Address reprint requests to Dr Hsu, Division of Thoracic Surgery, Taipei Veterans General Hospital, #201, Sec 2, Shei-Pai Rd, Taipei 112, Taiwan
e-mail: hcliu23{at}hotmail.com

Background. Thymic carcinoma is a malignancy of the anterior mediastinum, always with poor prognosis. Up to the present, very few articles have discussed and evaluated either the clinical or pathologic features or treatments of this tumor. Therefore, we are in a position to analyze our research data to support our belief as follows.

Methods. From January 1977 until December 1997, we received 614 patients who were diagnosed with anterior mediastinal tumors. Of the 614 patients, 38 patients (6.2%) were diagnosed with thymic carcinoma, including 26 men and 12 women. Data were collected from clinical records and personal interviews with the patients. Classification of these patients’ tumor stages was based on the Masaoka staging system.

Results. We proceeded with surgery for 15 of the 38 patients to remove their tumors. Complete resection was done in 8 of these 15 patients (21.0%), whereas debulking was done in the other 7 (18.4%) patients. The mean survival time of all the patients in this study (excluding 3 patients who were lost to follow-up) was 53.0 months, with a median of 24.1 months. The overall cumulative survival rate was 38.6% at 3 years and 27.5% at 5 years. The data in this research show that tumor grading (p = 0.01), resectability (p = 0.02), and stage (p = 0.04) have statistically significant influence on patients’ survival.

Conclusions. The grade, stage, and resectability of the tumor are decisive factors of the effectiveness of either surgery or chemo/radiotherapies in the treatment of thymic carcinoma.

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