Thymic Carcinoma: A Multivariate Analysis of Factors Predictive of Survival in 290 Patients

Background. Thymic carcinoma is a rare, aggressive disease with low 5-year survivals. We undertook this study to identify factors that impact prognosis and to better define the relationship between survival and surgical intervention. Methods. We queried the Surveillance, Epidemiology, and End Results cancer database and identified patients with thymic carcinoma. We performed univariate and multivariate analyses to identify factors prognostic for survival, focusing on demographic, tumor, and treatment variables. Results. For 290 patients with thymic carcinoma, the median survival was 48 months with 5-year survival of 30%. In multivariate analysis, type of surgical therapy (none, incomplete excision, complete thymic excision, debulking), Masaoka stage, and sex were important determinants of survival. Patients who underwent complete thymic excision had a significantly longer median survival than those who did not receive surgical therapy (105 versus 29 months; p < 0.001). In patients who underwent complete thymic excision, Masaoka stage and race were important determinants of survival in multivariate analysis. Conclusions. Complete thymic excision is the preferred primary treatment for thymic carcinoma. Masaoka stage has significant prognostic implications for all patients, including those who undergo complete thymic excision. (Ann Thorac Surg 2013;95:299-304) (C) 2013 by The Society of Thoracic Surgeons