Weekly chemotherapy with cisplatin, vincristine, doxorubicin, and etoposide followed by surgery for thymic carcinoma.

Objective: We present our experience treating the patients with thymic carcinoma using induction chemotherapy according to weekly chemotherapy with cisplatin, vincristine, doxorubicin, and etoposide (CODE) followed by surgery.

Methods: From January 2001 to December 2010, 17 patients were diagnosed as having thymic carcinoma at our hospital. We performed CODE chemotherapy for induction treatment followed by surgical resection in 7 of these patients.

Results: Seven patients consisted of 6 men and 1 woman, with an average age of 47.3 years (range 25-67 years). Five patients were clinically staged as Masaoka Stage III, and 2 were Stage IVa. A partial response was identified in 5 patients, and stable disease was observed in 2 patients. No cases of progressive disease were seen. Surgical resection was performed in all the patients: 6 underwent an R0 resection and 1 underwent an R1 resection. The estimated overall survival rates at 5 and 10 years were both 80%, and the relapse-free survival rates at 5 and 10 years were 68.6% and 53.6% respectively.

Conclusions: Induction chemotherapy using the CODE regimen, followed by a complete surgical resection can be performed with a promising survival outcome for patients with thymic carcinoma with borderline resectable lesions.