Long-term survival and prognosis after surgical treatment of patients with thymic carcinoma: a retrospective analysis.

Abstract

Background: Thymic carcinoma is a type of rare and highly malignant tumor that originates from the thymic epithelium. Treatment and prognosis of thymic carcinoma remain controversial. We retrospectively analyzed survival data from a large sample database in a single center in China to summarize the clinicopathological features of patients with thymic carcinoma and explore the factors affecting prognosis.

Methods: The clinical data of 87 patients with thymic carcinoma who underwent surgical treatment between January 2010 and October 2023 were retrospectively analyzed. Of these, 74 patients had thymic squamous cell carcinoma, and 13 had other subtypes. The Kaplan-Meier method was used to calculate survival rate, and the log-rank test was employed for univariate analysis. The Cox proportional hazards regression model was used for multivariate analysis to evaluate the clinical, pathological, and therapeutic information of patients with thymic carcinoma, analyze long-term survival, and identify prognostic factors associated with postoperative thymic carcinoma.

Results: The 5- and 10-year overall survival (OS) rates were 85.6% and 69.9%, respectively, and the corresponding disease-free survival (DFS) rates were 76.4% and 58.6%, respectively. Univariate analysis revealed significant associations between the Masaoka-Koga stage, resection status, postoperative radiotherapy, and OS in patients with thymic carcinoma. Furthermore, the Masaoka-Koga stage is correlated with DFS in patients who underwent postoperative treatment for thymic carcinoma. Cox multivariate analysis confirmed that the Masaoka-Koga stage [hazard ratio (HR): 2.719, 95% confidence interval (CI): 1.032-7.163, P=0.043] independently influenced DFS in surgically treated patients with thymic carcinoma, whereas the Masaoka-Koga stage (HR: 3.690, 95% CI: 1.043-13.049, P=0.043) and postoperative radiotherapy (HR: 0.319, 95% CI: 0.102-0.999, P=0.049) emerged as critical prognostic factors affecting OS.

Conclusions: Thymic squamous cell carcinoma is the most prevalent form of thymic carcinoma, and complete resection (R0 resection) is the preferred treatment modality. The Masaoka-Koga stage and postoperative radiotherapy are significant prognostic indicators for improved outcomes.