Prognostic Factors and Survival in Thymoma and Thymic Carcinoma: A Retrospective Cohort Study

Abstract

Objective: Thymic epithelial tumors (TETs), including thymomas and thymic carcinomas, are rare mediastinal cancers with distinct prognoses, and long-term real-world data on survival and prognostic factors remain limited. Methods: In this retrospective single-center study, 42 patients diagnosed between 2006 and 2024 were analyzed. Data on clinicopathological features, treatments, and survival were obtained from records. Survival was assessed using the Kaplan–Meier method with the log-rank test, and prognostic factors were evaluated using univariable Cox proportional hazards regression analysis. Results: The median follow-up duration was 38 months (range, 2-197 months). The median age at diagnosis was 52 years. Thymoma accounted for 81% of cases and thymic carcinoma for 19%. Complete resection (R0) was achieved in 67.7% of operated patients and was strongly associated with better survival, with a 5-year overall survival (OS) of 94% compared to 33% in incompletely resected tumors. De novo metastatic disease (hazards ratio [HR] = 15.3; 95% CI: 3.39-69.20) and R2 resection (HR = 8.64; 95% CI: 2.65-28.18) were significantly associated with poorer OS. No statistically significant difference in survival was observed between patients who received mediastinal radiotherapy and those who did not. Conclusions: Complete resection remains the cornerstone of survival in TETs. Metastatic and incomplete resection are associated with poor outcomes. No statistically significant difference in survival was observed between patients who received mediastinal radiotherapy and those who did not. These findings provide real-world evidence to guide clinical management of these rare malignancies.   Cite this article as: Türkoğlu E, Işık D, Buser NS, et al. Prognostic factors and survival in thymoma and thymic carcinoma: a retrospective cohort study. Cerrahpaşa Med J 2026, 50, 0089, doi: 10.5152/cjm.2026.26089.