Outcome of surgically resected thymic carcinoma: A multicenter experience
Menée en Italie sur 40 patients atteints d'un carcinome du thymus, cette étude multicentrique évalue, du point de vue des taux de survie à 5 et 10 ans, l'intérêt d'une résection complète dans le cadre d'un traitement multimodal
Objective : Thymic Carcinoma (TC) is a rare and invasive mediastinal tumor, with poor prognosis. Most of the previous published papers are single-Institution based, reporting small series of patient, sometimes including palliative resection. This study collected patients with TC treated in 5 high-volume Italian Thoracic Surgery Institutions. Methods : a multicenter retrospective study of patients operated for TC between 2000 and 2011, was conducted. Exclusion criteria were: Neuroendocrine Thymic neoplasms, debulking/palliative resection and tumor biopsy. Cause specific survival (CSS) was the primary endpoint. Results : Four hundred seventy-eight patients underwent surgery for Thymic Malignancies: 40 of them (8.4%) had TC. Eleven (27.5%) received induction chemotherapy because of their radiological invasiveness. A complete resection (R0) was achieved in 36 (90%; 9/11 submitted to induction chemotherapy). Adjuvant radio/chemotherapy was offered to 37 patients, according to the type of surgical resection and tumor invasiveness. Three, 5 and 10-year survival rates were 79%, 75% and 58%. Recurrences developed in 10 patients. R0 resection (p < .0003) and absence of tumor recurrences (p = .03) resulted significant prognostic factors at univariate analysis. Independent CSS predictor was the achievement of a complete resection (p < .05). Conclusions : TC is a rare and invasive mediastinal tumor. A multimodal approach is indicated especially in TC invasive forms. The achievement of a complete surgical resection is fundamental to improve survival.