Prognostic Factors of Patients with Thymic Carcinoma After Surgery: A Retrospective Analysis of 58 Cases

Thymic carcinoma is reputed to carry a poor prognosis. Although few scholars have studied the prognosis of thymic carcinoma, the prognostic factors of patients after surgery are not well established. We analyze the prognostic significance of undetermined factors to predict the survival of patients after surgery. We reviewed 351 cases of thymic epithelial tumor treated with surgery at a single institution in China from 1992 to 2011. A total of 58 patients were histopathologically reconfirmed as having thymic carcinoma. Clinicopathological characteristics and treatment modalities were reviewed. During the follow-up, with a median of 65.8 months, survival time was analyzed using the Kaplan-Meier method. Univariate and multivariate analysis were performed to identify prognostic factors. The overall 3-, 5-, and 10-year survival rate was 69.0, 43.1, and 12.1 %, respectively. The Log-rank test revealed that Masaoka stage (p = 0.000), histology group (p = 0.000), completeness of the resection (p = 0.000), great vessel invasion (p = 0.000), and presence of symptoms (p = 0.003) were significant prognostic factors in all patients. However, tumor size (p = 0.086), age (p = 0.677), sex (p = 0.706), smoking (p = 0.065), and alcohol (p = 0.875) were not prognostic factors. A Cox proportional hazards regression model showed that Masaoka stage (hazard ratio = 15.640, p = 0.000) and completeness of the resection (hazard ratio = 18.303, p = 0.000) were the only independent prognostic factors. The Masaoka stage and completeness of the resection were independent prognostic factors that predicted long-term survival of patients with thymic carcinoma treated with surgery.