Abstract
ObjectivesThymic squamous cell carcinoma (TSCC) is a rare neoplasm that has been sparsely cited in the literature. The aim of this study was to determine disease characteristics and prognostic factors of patients in a Surveillance, Epidemiology, and End Results (SEER) analysis.MethodsCases from 1990–2016 were retrieved from the SEER database and demographics, treatments, and survival outcomes were analyzed.ResultsThe TSCC accounted for 72.4% of the thymic carcinomas and 7.2% of thymic tumors. The 276 patients (165 men) selected for analysis had a median age of 65 (24–85) years, and 201 patients were diagnosed with Masaoka-Koga stage III/IV. The median survival of TSCC was 59 months with a 49.0% 5-year OS rate, a better prognosis than lymphoepithelioma-like carcinoma (32.1%) and undifferentiated carcinoma (33.3%). Multivariate analysis revealed the Masaoka-Koga stage (p = 0.003) and surgical types (complete resection, incomplete resection, and none; p < 0.001) were determinants of survival. Complete resection had the best prognosis with a 72.7% 5-year OS rate. Chemotherapy was an independent protective factor (HR = 0.555, 95% CI 0.347–0.886; p = 0.014) though poor survival was showed in univariate analysis. And the survival benefit of chemotherapy was validated in PSM analysis (3-year OS rate was 77.7% with chemotherapy vs. 52.8% without chemotherapy; p = 0.014).ConclusionsTSCC was frequently diagnosed in older patients with advanced Masaoka-Koga stage and had more favorable survival than other subtypes of thymic carcinomas. Complete resection is the preferred treatment. Masaoka-Koga stage and chemotherapy had a strong association with prognosis.
Highlights
Thymic neoplasms are rare tumors that account for less than 1% of all adult cancers [1]
MasaokaKoga stage yielded 55 cases with stage I/IIA, 20 with stage IIB, 64 with stage III, and 137 cases with stage IV. 56.5% of the patients received radiotherapy and chemotherapy was applied in 59.1%
Our study demonstrated that complete resection had the best survival outcome
Summary
Thymic neoplasms are rare tumors that account for less than 1% of all adult cancers [1]. Thymic epithelial neoplasms are major thymic neoplasms subtypes that comprise thymomas and thymic carcinomas. The outline of thymomas has been well clarified compared with thymic carcinomas as its advantage on larger cases. Different from the tumors of other sites using the TNM stage system, the most widely accepted clinical staging system in thymoma is the Masaoka stage. Was developed by Masaoka et al in 1981 and modified subsequently by Koga et al in 1994. The Masaoka stage was applied in thymic carcinomas in many series [2, 3]. Thymic carcinomas represent a heterogeneous group of tumors that exhibit more aggressive malignant behaviors compared to thymomas [4]
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