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The presence of extrathoracic metastasis is more prognostic of survival than Masaoka stage (IVa/IVb) in metastatic thymic epithelial tumor: A retrospective cohort study

Cited 5 time in Web of Science Cited 5 time in Scopus
Authors
Shin, Dong-Yeop; Kim, Dong-Wan; Keam, Bhumsuk; Kim, Tae Min; Lee, Se-Hoon; Kang, Chang Hyun; Kim, Young Tae; Heo, Dae Seog
Issue Date
2014-08
Citation
Lung Cancer, Vol.85 No.2, pp.320-325
Keywords
Thymic epithelial tumorPrognostic factor, Masaoka stage IVExtrathoracic metastasisOverall survivalNeoplasm
Abstract
Purpose: Our aim in this study was to identify independent prognostic factors for overall survival (OS) in order to explain the heterogeneity of OS in patients with metastatic thymic epithelial tumor (TET). Methods: Sixty-one consecutive patients with histologic diagnosis of Masaoka stage IV TET between January 1980 and March 2009 were analyzed at a single institution. Masaoka stage IVa was defined as pleural or pericardial dissemination, and IVb as lymphogenous or hematogenous metastasis. Metastasis outside the thoracic cage was defined as extrathoracic metastasis. To identify prognostic factors, relationships between clinicopathologic factors and outcomes were analyzed. Results: Of the 61 patients, 30(49.2%) had thymoma, 28(45.9%) had thymic carcinoma, and the remaining 3(4.9%) had an unclear histologic subtype. The Masaoka stage was IVa in 27 patients (44.3%) and IVb in 34 patients (55.7%). Significant independent adverse prognostic factors for OS were histologic subtype and extrathoracic metastasis (hazard ratio [HR] = 3.09 and 6.03, 95% CI: 1.41-6.74 and 1.89-19.30, p = 0.005 and 0.002, respectively). The presence of extrathoracic metastasis was also an independent prognostic factor for decreased progression-free survival time (PFS) (HR = 6.62, 95% CI: 1.19-24.17, p = 0.004). The only significant criterion for prognostic discrimination was the presence of extrathoracic metastasis in metastatic TET. Conclusions: Significant independent prognostic factors for lower OS were the histologic subtype of thymic carcinoma and the presence of extrathoracic metastasis. A new concept of extrathoracic metastasis might provide additional information for the understanding of metastatic TET. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
ISSN
0169-5002
URI
http://hdl.handle.net/10371/165400
DOI
https://doi.org/10.1016/j.lungcan.2014.05.021
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College of Medicine/School of Medicine (의과대학/대학원)Cancer Research Institute (암연구소)Journal Papers (저널논문_암연구소)
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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