Clinical Characteristics and Outcomes for Patients With Thymic Carcinoma: Evaluation of Masaoka Staging

Litvak, Anya M.; Woo, Kaitlin M.; Hayes, Sara A.; Huang, James; Rimner, Andreas; Sima, Camelia S.; Moreira, André L.; Tsukazan, Maria Teresa Ruiz; Riely, Gregory J.

doi:10.1097/jto.0000000000000363

Cited by 60 publications

(51 citation statements)

References 27 publications

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“…The poor prognosis of thymic carcinoma emphasizes the dilemma of the lack of effective systemic treatment options. 10,11 Paclitaxel is a cytoskeletal drug that targets tubulin. Its mechanism of action involves interference with the normal breakdown of microtubules during cell division.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of the combination of paclitaxel and platinum in advanced thymic carcinoma

Hao

Zhang

et al. 2015

Thoracic Cancer

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This study aimed to assess the efficacy and safety of a combination of paclitaxel and cisplatin/carboplatin for the treatment of advanced thymic carcinoma. Thirty‐seven patients (23 men and 14 women, median age 47 years, performance status score ≤2) with pathologically or cytologically diagnosed advanced thymic carcinoma were recruited. Patients received 175 mg/m2 paclitaxel on day 1 and 75 mg/m2 cisplatin or 300 mg/m2 carboplatin on day 2 of a 21 day cycle for at least two cycles to evaluate efficacy and adverse events. No complete response (CR) was observed; 11 patients had a partial response (PR), 16 patients had no change (NC), and 10 had progressive disease, resulting in an overall response rate of 29.7%, a stable rate of 43.2%, and a disease control rate (CR + PR + NC) of 72.9%. Grade I/II and III/IV neutropenia were observed in 21 (56.7%) and 13 (35.1%) patients, respectively. Four (10.8%) patients developed grade I/II thrombocytopenia. Grade I/II and III/IV nausea and vomiting were observed in 19 (51.2%) and five (13.5%) patients, respectively. Grade I/II liver dysfunction was observed in seven (18.9%) patients. Two patients with grade III liver dysfunction recovered after hepatoprotective treatment. The combination of paclitaxel and platinum was effective and well tolerated in patients with advanced thymic carcinoma.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of the combination of paclitaxel and platinum in advanced thymic carcinoma

Hao

Zhang

et al. 2015

Thoracic Cancer

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“…The expression of Kit was also used as a diagnostic tool of these tumors [39,93] [8,31,67]. Nine studies reported that the staging wasn't a relevant prognostic factor [6,9,19,20,30,46,57,71,74]. These studies reported that the vascular invasion was a bad prognosis factor and that it needs to be integrated in the staging system [46,57,71].…”

Section: Discussionmentioning

confidence: 99%

“…This study highlights the rarity of thymic carcinomas that account for 1 to 4% of all malignant tumors of the thymus and between 10 to 20% of thymic epithelial tumors [11,12,[13][14][15][16][17][18][19][20][21][22][23][24][25][26]. .…”

Section: Discussionmentioning

confidence: 99%

Review of the literature about Thymic Carcinomas

Mlika¹,

Mezni²

2017

Arch Pulmonol Respir Care

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Background: Thymic carcinomas (TC) are rare tumors with challenging diagnosis and management. We aimed to describe the clinical and microscopic characteristics of TC through a literature review.Results: 82 articles and abstracts were retained about 2913 TC. Our study contained 1760 men and 1153 women with a mean age of 55.32 years. The delay of diagnosis was specifi ed in 10 cases and varied between 8 months and 2 years. Symptoms consisted mainly in chest pain and dyspnea. The Computed Tomography-scan (CT-scan) fi ndings were specifi ed in 63 cases. Microscopic fi ndings were noticed in 1766 cases. They consisted mainly in squamous cell carcinoma in 1297 cases and undifferentiated carcinoma in 239 cases. The patients presented stage 1 tumors in 165 cases, stage II in 362 cases, stage III in 1011 cases and stage IV in 1166 cases. The treatment modalities were noticed in 2803 cases. There was no consensus of the regimen of chemotherapy or the place of the radiation therapy but all studies highlighted the key role of the complete surgical resection when possible. Conclusion:Our results highlight the lack of consensual management of TC. The chemotherapy regimen, the second-line chemotherapy and the indications of radiation therapy seem non-consensual and need further studies. Many interrogations remain concerning the management of these tumors according to their histologic grade. The real place of targeted therapy remains to assess and the rare opinions published are based on rare and non-representative cases.

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“…Thymic carcinoma prognostic factors include Masaoka-Koga stage [11, 12], resection status [11, 13], pathological subtype [1], and innominate vessel invasion [8]. Most patients with thymic carcinoma present with advanced disease at initial diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Stage IVb thymic carcinoma: patients with lymph node metastases have better prognoses than those with hematogenous metastases

et al. 2017

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BackgroundThis study aimed to analyze the pattern of lymphogenous and hematogenous metastases in patients with stage IVb thymic carcinomas and identify prognostic factors for their survivals.MethodsBetween September 1978 and October 2014, 68 patients with pathologically confirmed stage IVb thymic carcinomas were treated at Fudan University Shanghai Cancer Center. Forty-three patients had lymph node involvement without distant metastases, and the remaining 25 patients had hematogenous metastases. Clinical-pathological characteristics, including age, sex, histologic subtype, tumor size, metastasis, treatment modalities, such as surgical resection, radiotherapy, and chemotherapy, and clinical outcomes, such as overall survival (OS) and progression free survival (PFS), were analyzed.ResultsThe median follow-up time was 22 months (range, 1–126 months). The median OS of all patients with stage IVb thymic carcinomas was 30 months, and the 5-year overall survival rate was 25.1%. The median PFS was 11 months, and the 5-year PFS was 17.9%. Stage IVb patients with lymph node involvement had a better survival than those with distant metastasis (40 vs. 20 months, p = 0.002). Patients with myasthenia gravis had a worse prognosis (p = 0.033). Multivariate analysis identified metastatic status as an independent prognostic factor for OS in patients with stage IVb thymic carcinomas.ConclusionsPatients with lymph node involvement had a better survival than those with distant metastases. Much work remains to investigate the prognosis of patients with stage IVb thymic carcinomas and to explore different treatment strategies for patients with lymph node involvement and distant metastases.

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Clinical Characteristics and Outcomes for Patients With Thymic Carcinoma: Evaluation of Masaoka Staging

Cited by 60 publications

References 27 publications

Efficacy and safety of the combination of paclitaxel and platinum in advanced thymic carcinoma

Efficacy and safety of the combination of paclitaxel and platinum in advanced thymic carcinoma

Review of the literature about Thymic Carcinomas

Stage IVb thymic carcinoma: patients with lymph node metastases have better prognoses than those with hematogenous metastases

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