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Neuroendocrine tumors of the thymus (NETTs) are rare but aggressive, and lead to poor overall survival. This retrospective study was designed to analyze factors that correlate with the prognosis of patients with NETTs.From 1999 to 2015, 41 ongoing patients with NETTs were enrolled in this study. The clinical data and outcome were compiled. Overall survival (OS) rate was analyzed using the Kaplan-Meier method in univariate analysis and the Cox-model was used in multivariate analysis.Of the 41 NETTs patients analyzed (31 male and 10 female), 12 were typical carcinoma, 14 were atypical carcinoma, 14 were small-cell carcinoma and, 1 was large-cell carcinoma. The median follow-up time was 29 months (range, 9.0-69.0). In total, 25 patients died of cancer-related disease by the last follow-up. The 3- and 5-year survival rates for all patients were 42.7% and 23.4%, respectively. Among the prognostic factors analyzed by multivariate analysis, low tumor grade, complete resection, and a negative chromogranin A (CgA) expression were positively correlated with survival.The surgical treatment of NETTs, CgA negative, and low grade of NETTs were associated with a statistically significant better prognosis. However, large, multicenter studies are required to fully validate these prognostic factors.

Positron emission tomography/integrated computed tomography (PET/CT) provides the most accurate imaging modality for preoperative lung cancer staging. However, the diagnostic accuracy of maximum standardized uptake value (SUVmax) for mediastinal (N2) lymph nodes (LN) is unclear. We compared SUVmax, the ratio of LN to primary tumor SUVmax (SUVn/t), and SUVn/t multiplied by maximal tumor diameter (SUVindex) in terms of their abilities to predict mediastinal LN malignancy. We retrospectively analyzed 170 mediastinal LN stations from 73 consecutive patients who underwent systemic LN resection and PET/CT within 27 days. The SUVmax of the primary tumors was >2.0 and the SUVmax of the mediastinal LN stations ranged from 2.0 to 7.0 on PET/CT. Receiver-operating characteristic curves (ROCs) of SUVmax, SUVn/t, and SUVindex were calculated separately and the areas under the curves (AUCs) were used to assess the abilities of the parameters to predict LN malignancy. The optimal cutoff values were calculated from each ROC curve and the diagnostic abilities were also compared. The diagnostic accuracies of the 3 methods were also assessed separately in smoking and nonsmoking patients. Twenty-eight LN stations were malignancy-positive and the remaining 142 were malignancy-negative. The AUCs for SUVindex, SUVn/t, and SUVmax were 0.709, 0.590, and 0.673, respectively, and the optimal cutoff values for SUVindex, SUVn/t, and SUVmax were 1.11, 0.34, and 3.6, respectively. The differences between SUVindex and SUVn/t were significant, but there was no significant difference between SUVindex and SUVmax. There were no significant differences between smokers and nonsmokers in the AUCs for any of the methods for predicting LN malignancy (P values >0.05). SUVindex may be a predictor of mediastinal LN malignancy in lung cancer patients.