Thymic Carcinoma: Current Staging Does Not Predict Prognosis

Blumberg, David; Burt, Michael; Bains, Manjit S.; Downey, Robert J.; Martini, Nael; Rusch, Valerie W.; Ginsberg, Robert J.

doi:10.1016/s0022-5223(98)70273-9

Cited by 153 publications

(126 citation statements)

References 22 publications

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“…Although there are reports in the literature [8,9] that SCC had a better prognosis than other histologic types of thymic carcinoma, our results did not show this tendency. Contrary to Blumberg and colleagues' [12] report, our data revealed that the prognosis of WD SCC was better than other types of thymic carcinoma. Well-differentiated SCC was defined as low-grade malignancy and was reported as the most reliable predictor of prognosis [4, 6, 9].…”

Section: Commentcontrasting

confidence: 99%

“…Herein we reported one of the largest series published thus far. The prevalence of thymic carcinoma compared with all thymic malignant neoplasms was similar to the reports by Hsu and colleagues [11] and Blumberg and colleagues [12]. In Taiwan, the incidence of thymic carcinoma seems higher than in Western countries [8 -11].…”

Section: Commentsupporting

confidence: 84%

“…Some reports suggest that tumor resectability, tumor stage, tumor grading, or postoperative radiotherapy influenced the outcome [4, 6, 8 -11]. The largest clinical report by Blumberg and colleagues [12] showed that innominate vessel invasion was the only prognostic factor and that Masaoka stages could not predict prognosis. We treated 40 patients with thymic carcinoma from July 1988 to January 2002, and we reported that thymic carcinomas had a high percentage of bcl-2 and mcl-1 expression [13,14], which indicated their malignant behavior.…”

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Thymic carcinoma: involvement of great vessels indicates poor prognosis

Tseng¹,

Wang²,

Wu³

et al. 2003

The Annals of Thoracic Surgery

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Background. Thymic carcinoma is a rare, indolent, and invasive cancer. This study investigated the treatment results of thymic carcinoma and clinical prognostic factors.Methods. From June 1988 to January 2002, 38 patients were enrolled in this study with the diagnosis of thymic carcinoma in the Cheng-Kung University Hospital based on Rosai's and Muller-Hermelink's classification. Clinical and pathologic data were retrospectively reviewed. Survival analysis was performed using the KaplanMeier, log rank, and Wilcoxon tests. Statistical significance was defined as p < 0.05.Results. Pathology revealed 14 poorly differentiated, 6 moderately differentiated, and 8 well-differentiated squamous cell carcinomas; 8 lymphoepithelioma-like carcinomas; and 2 other carcinomas. Pathologic staging using the Masaoka system included 6 stage II, 23 stage III, and 9 stage IV patients. Six biopsies, five debulkings,

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Section: Commentcontrasting

confidence: 99%

Section: Commentsupporting

confidence: 84%

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confidence: 99%

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Thymic carcinoma: involvement of great vessels indicates poor prognosis

Tseng¹,

Wang²,

Wu³

et al. 2003

The Annals of Thoracic Surgery

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“…Therefore, patients with WDTC or type B3 tumors were included in the current study to focus on the prognosis of patients with thymoma, whereas patients with these tumors previously were included in the analysis of patients with thymic carcinomas. 36 The poorer survival and the higher tumor recurrence rate in the patients with type B3 tumors compared with other types of thymomas, however, seem to indicate more careful follow-up and treatment for these patients compared with the treatment for patients with other types of thymomas.…”

Section: Discussionmentioning

confidence: 99%

The World Health Organization histologic classification system reflects the oncologic behavior of thymoma

Okumura

Ohta

Tateyama

et al. 2002

Cancer

553

414

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BACKGROUNDAlthough the histologic classification of thymic epithelial tumors has been confusing and controversial, an agreement on the universal classification system for thymic epithelial tumors was achieved by the World Health Organization (WHO) in 1999. The authors previously reported that the WHO histologic classification system reflects invasiveness and immunologic function of thymic epithelial tumors. In this subsequent study, they examined the prognostic significance of this classification system.METHODSClinical features as well as postoperative survival of patients with thymoma, but not thymic carcinoma, were examined with reference to WHO histologic classification based on an experience with 273 patients over a 44‐year period.RESULTSThere were 18 type A tumors, 77 type AB tumors, 55 type B1 tumors, 97 type B2 tumors, and 26 type B3 tumors. In patients with type A, AB, B1, B2, and B3 tumors, the respective proportions of invasive tumor were 11.1%, 41.6%, 47.3%, 69.1%, and 84.6%; the respective proportions of tumors with involvement of the great vessels were 0%, 3.9%, 7.3%, 17.5%, and 19.2%; and the respective 20‐year survival rates were 100%, 87%, 91%, 59%, and 36%. According to the Masaoka staging system, the 20‐year survival rates were 89%, 91%, 49%, 0%, and 0% in patients with Stage I, II, III, IVa, and IVb disease, respectively. By multivariate analysis, the Masaoka staging system and the WHO histologic classification system were significant independent prognostic factors, whereas age, gender, association with myasthenia gravis, completeness of resection, or involvement of the great vessels were not significant independent prognostic factors.CONCLUSIONSThis study showed that histologic appearance reflects the oncologic behavior of thymoma when the WHO classification system is adopted. The WHO classification system may be helpful in clinical practice for the assessment and treatment of patients with thymoma. Cancer 2002;94:624–32. © 2002 American Cancer Society.DOI 10.1002/cncr.10225

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“…Okumura and associates (37) reported that involvement of the great vessels is an independent prognostic factor in patients with stage III thymoma. 4) The system is not well suited to staging thymic carcinomas (38,39). The TNM system classification of thymic epithelial tumors has not been established.…”

Section: Clinical Stagementioning

confidence: 99%

Optimal therapy for thymoma

Kondo

2008

J. Med. Invest.

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: Thymoma is the most common tumor of the anterior mediastinum. This tumor is associated with unique paraneoplastic syndromes (myasthenia gravis, pure red cell aplasia, hypogammaglobulinemia, and other autoimmune diseases). The rarity of this tumor has somewhat obscured the optimal treatment. Although the histologic classification of thymoma has remained a subject of controversy for many years, the WHO classification system, published in 1999, appeared to be an advance in our understanding of thymoma. The optimal treatment for thymoma depends on its clinical stage. Surgery remains the mainstay of treatment for thymic epithelial tumors. Thymomas also have a high response rate to chemotherapy or radiotherapy. Only surgical resection is performed for patients with stage I (non-invasive) thymoma. The value of postoperative radiotherapy in completely resected stage II or III tumors is questionable. Multimodality therapy involving surgery, chemotherapy and radiotherapy appears to increase the rate of complete resection and survival in advanced (stage III and IV) thymomas. J. Med. Invest. 55 : 17-28,

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Thymic Carcinoma: Current Staging Does Not Predict Prognosis

Cited by 153 publications

References 22 publications

Thymic carcinoma: involvement of great vessels indicates poor prognosis

Thymic carcinoma: involvement of great vessels indicates poor prognosis

The World Health Organization histologic classification system reflects the oncologic behavior of thymoma

Optimal therapy for thymoma

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