Impact of metastasis site for survival of patients with advanced thymic epithelial tumors

Abstract

Background: The aim of present study was to investigate the impact of metastasis site for the survival of patients with advanced thymic epithelial tumors (TET). Methods: A retrospective review was conducted to investigate the medical records of patients with advanced TET between 2005 and 2015 in Zhejiang Cancer Hospital. Clinicopathologic characteristics, treatment and prognosis information were collected. Survival curves were plotted using the Kaplan-Meier method and comparison with log-rank. Multivariate analysis was estimated using the Cox proportional hazard model. Results: Totally, 92 patients were recruited including 57 of males and 35 females with median age of 51 years old. Thirty-one patients were with thymoma and 61 with thymic carcinoma. Thirty-six patients were with stage IVa and 56 with IVb. The metastasis sites were as follows: plural/pericardial (n=35), lung (n=29), lymph nodes (n=18), bone (n=16), liver (n=13), brain (n=3) and other sites (n=8). Among these, 20 were multi-sites metastasis. The median overall survival for all patients was 25.4 months (95% CI: 21.7–29.1). The median overall survival was shorter in patients with than that without liver metastasis (15.9 vs . 26.6 months, P=0.015). A same trend was found in patients with and without brain metastasis (14.5 vs . 25.6 months, P=0.013). In multivariate analyses, the brain and liver metastasis were independent unfavorable prognostic factors (P were 0.015 and 0.008, respectively). Conclusions: Our results suggest of TET with different metastasis sites may have diverse prognosis. Liver and brain metastasis were unfavorable factors for survival of TET patients.