OBJECTIVE To retrospectively evaluate the prognostic factorsfor advanced thymic carcinoma.METHODS The data from 45 patients with advanced thymiccarcinoma were retrospectively analyzed according to Masaokastage criteria. There were 29 Stage Ⅲ patients and 16 StageⅣ patients (13 Stage ⅣA patients and 3 Stage ⅣB patients).According to the World Heath Organization Histological Criteria(2004), 25 cases were identified as low-grade and 20 caseswere identified as high-grade. All diagnoses were confirmedby biopsy. Five patients underwent gross total resection, 21patients underwent subtotal resection and 19 patients underwentbiopsy alone. Forty-two patients received radiotherapy with amedian dose of 60 Gy, and 37 patients underwent conventionalradiotherapy, including local irradiation and expanded irradiation.Local irradiation volume covered the primary tumor bed andapproximately 1-2 cm~2 surrounding the tumor (according topreoperative imaging). Expanded irradiation volume coveredthe full mediastinal and pericardium areas (with or withoutprophylactic irradiation in the supraclavicular area). Five casesreceived stereotactic radiotherapy. Thirty-one patients were alsotreated with chemotherapeutics, including Cisplatin, VP-16,Endoxan, 5-FU and taxol.RESULTS The median follow-up period was 59 months. Theoverall 3-year survival rate was 57.8%, and the median survivalwas 45 months. Univariate statistical analysis showed that thehistological subtype and Masaoka stage were prognostic factors.The 3-year survival rate was 61.9% in patients treated withgross total resection and 55.0% in those who underwent biopsyonly. The 3-year survival rate was 59.5% in patients treatedwith conventional radiotherapy and 80% in those treated withstereotactic radiotherapy. The 3-year survival rate was 64.5% inpatients treated with simultaneous chemotherapy and 42.9%in patients treated without simultaneous chemotherapy (P >0.05). Chemotherapy in combination with radiation treatmentand surgery achieved better outcomes for Stage Ⅳ patients thanradiation treatment and surgery without chemotherapy (P < 0.05).CONCLUSION For patients with Stage Ⅲ and Ⅳ thymiccarcinoma, complete resection and postoperative radiotherapy orfractionated stereotactic radiotherapy constitute the best treatmentsolution. Chemotherapy can also be used in combination toimprove prognosis. For patients with Stage Ⅳ thymic carcinoma,chemotherapy is necessary. OBJECTIVE To retrospectively evaluate the prognostic factors for advanced thymic carcinoma. METHODS The data from 45 patients with advanced thymiccarcinoma were retrospectively analyzed according to Masaokastage criteria. There were 29 Stage III patients and 16 Stage IV patients (13 Stage IVA patients and 3 Stage IVB patients). According to the World Heath Organization Histological Criteria (2004), 25 cases were identified as low-grade and 20 cases were identified as high-grade. All diagnoses were confirmed by biopsy. Five patients underwent gross total resection, 21 patients underwent subtotal resection and 19 patients underwent biopsy alone. Forty-two patients received radiotherapy with a medium dose of 60 Gy, and 37 patients underwent conventionalradiotherapy, including local irradiation and expanded irradiation. Local irradiation volume covered the primary tumor bed andapproximately 1-2 cm ~ 2 surrounding the tumor (according top top surgical imaging Expanded irradiation volume covered the fu Thirty-one patients were alsotreated with chemotherapeutics, including Cisplatin, VP-16, Endoxan, 5-FU and taxol .RESULTS The median follow- The 3-year survival rate was 57.8%, and the median survival was 45 months. Univariate statistical analysis showed that thehistological subtype and Masaoka stage were prognostic factors. The 3-year survival rate was 61.9% in patients treated withgross The 3-year survival rate was 64.5% inpatients treated with simultaneous chemotherapy and 42.9% inpatients treated with conventional radiotherapy and 80% in those treated with conventional radiotherapy and 80% in those who underwent biopsyonly. % in patients treated without medication chemotherapy (P> 0.05). Chemotherapy in combination with radiation treatment and surgery ac hievedbetter outcomes for Stage IV patients than radiation treatment and surgery without chemotherapy (P <0.05) .CONCLUSION For patients with Stage III and IV thymiccarcinoma, complete resection and postoperative radiotherapy or fractionated stereotactic radiotherapy constitute the best treatmentsolution. Chemotherapy can also be used in combination toimprove prognosis For patients with Stage Ⅳ thymic carcinoma, chemotherapy is necessary.