{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T08:29:13Z","timestamp":1786609753518,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Thymomas and thymic carcinomas are rare diseases with limited clinical evidence. This study aimed to investigate the clinical characteristics of and treatment practices for Stages III and IV thymoma or thymic carcinoma in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed cases of Stage III and IV thymoma and thymic carcinoma diagnosed between 2018 and 2022 and recorded in a nationwide dataset linking the Hospital\u2010based Cancer Registry and the Diagnosis Procedure Combination survey. Treatment practices, including the use of perioperative chemotherapy, radiotherapy, and newer systemic therapies as well as the chemotherapy regimens, were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 556 stage III thymoma, 312 stage III thymic carcinoma, 431 stage IV thymoma, and 976 stage IV thymic carcinoma patients were identified. Postoperative radiotherapy after complete resection was more common for stage III thymic carcinoma than for thymoma (34.1% vs. 10.7%), while perioperative chemotherapy was used more frequently for stage IV thymoma than for thymic carcinoma (preoperative: 15.5% vs. 3.7%; postoperative: 8.4% vs. 4.4%). For stage IV thymoma, adriamycin\u2013cisplatin\u2013vincristine\u2013cyclophosphamide was the most common regimen (41.8%), whereas carboplatin\u2013paclitaxel was predominantly used for stage IV thymic carcinoma (99.5%). The proportion of anthracycline\u2010based therapy for stage IV thymoma increased from 50.0% to 77.8%, while that of postoperative radiotherapy for stage III thymoma decreased from 11.1% to 4.1%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Evidence\u2010based treatment approaches for thymoma and thymic carcinoma have been widely adopted in Japan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1759-7714.70367","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:20:23Z","timestamp":1785507623000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced Thymoma and Advanced Thymic Carcinoma Treatment Practices in 2018\u20132022: A Nationwide Analysis in Japan"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9137-2446","authenticated-orcid":false,"given":"Junichi","family":"Ishigaki","sequence":"first","affiliation":[{"name":"Department of Public Health and Health Policy, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Department of Respiratory Medicine, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Rare Cancer Center National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0232-8283","authenticated-orcid":false,"given":"Ryoko","family":"Rikitake","sequence":"additional","affiliation":[{"name":"Department of Public Health and Health Policy, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Division of Health Services Research Institute for Cancer Control, National Cancer Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3658-4442","authenticated-orcid":false,"given":"Hidenori","family":"Kage","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9933-2106","authenticated-orcid":false,"given":"Takahiro","family":"Higashi","sequence":"additional","affiliation":[{"name":"Department of Public Health and Health Policy, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Division of Health Services Research Institute for Cancer Control, National Cancer Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Japan Lung Cancer Society \u201cGuidelines for the Diagnosis and Treatment of Lung Cancer\/Malignant Pleural Mesothelioma\/Thymic Tumors 2025 (in Japanese) \u201daccessed 12 April 2025 https:\/\/www.haigan.gr.jp\/publication\/guideline\/examination\/2025\/."},{"key":"e_1_2_11_3_1","volume-title":"WHO Classification of Tumours of Soft Tissue and Bone","author":"WHO Classification of Tumors Editorial Board","year":"2020"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resinv.2025.09.005"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2025.0027"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv277"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(19910701)68:1<30::AID\u2010CNCR2820680106>3.0.CO;2\u20104"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.6.1164"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605347"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2003.12.010"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e31802bafc8"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(20010601)91:11<2010::AID\u2010CNCR1226>3.0.CO;2\u20102"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.32.9607"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.3.814"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu541"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000362"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyt001"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyt013"},{"key":"e_1_2_11_19_1","volume-title":"TNM Classification of Malignant Tumors","author":"Brierley J. 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