THYMIC CARCINOMA - CURRENT STAGING DOES NOT PREDICT PROGNOSIS

Background: Thymic carcinomas are currently staged by Masaoka classifi cation, a staging system for thymomas. We retrospectively evaluated su rgical patients with thymic carcinoma to determine prognostic factors and to evaluate the usefulness of Masaoka staging in this disease, Met hods: Our computerized tumor registry yielded 118 patients with thymom a, Review of pathologic material revealed 43 cases of thymic carcinoma , Collection of data was by review of hospital and physician charts an d telephone contact with patients. Analysis of prognostic factors was performed in patients undergoing complete resection by the method of K aplan-Meier and Cox proportional hazards regression, Results: Between 1949 and 1993, 43 patients underwent surgery for thymic carcinoma, Ove rall survival was 65% at 5 years and 35% at 10 years, Overall recurren ce was 65% at 5 years and 75% at 10 years, On univariate analysis, sur vival was not dependent on age, sex, tumor size, or Masaoka stage but was dependent on innominate vessel invasion, By multivariate analysis, survival was dependent only on innominate vessel invasion, Conclusion s: Patients with thymic carcinoma have a high rate of recurrence, Tumo r invasion of the innominate vessels is associated with a particularly poor prognosis, Although Masaoka staging is useful in staging patient s with thymoma, it does not appear to predict outcome for patients wit h thymic carcinoma.