J Thorac Cardiovasc Surg 1999;117:630
© 1999 Mosby, Inc.
Well-differentiated thymic carcinoma: Is it thymic carcinoma or not?
Robert J. Ginsberg, MD,
New York City, NY
Department of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York City, NY, 10021
Reply to the Editor:
My colleagues and I thank Masaoka and his associates for their letter and discussion. The authors point out one of the problems in dealing with tumors of the thymus: a variety of pathologic classifications have been devised, and the recent introduction of new classifications has caused a significant amount of confusion. A single classification of thymic tumors is greatly needed.
We agree that well-differentiated thymic carcinoma is different from type II malignant thymoma. The point of our article was that both of these malignant diseases can be aggressive. We found that the tumors with the worst prognosis were those invading the innominate vein. Regardless of the pathologic diagnosis, fewer than 50% of patients treated for such tumors with complete resections will be disease-free at 5 years, despite surviving. As Fig 1 in our original article demonstrates, even stage I and II thymic carcinoma will have a propensity to recur. In 10 years, 90% of thymic carcinomas of either type will recur, despite complete resection.
We therefore concluded that either of these entities requires a much more aggressive management and might benefit from multimodality therapy.
