The first question is on the indication of surgery for thymic carcinoma. Thymic carcinoma was shown to be an independent significant factor for poor outcome in overall survival, cause-specific survival and freedom from recurrence in this study. The hazard ratio was 6.5, 13.1 and 2.4, respectively, in each of the analyses. Five-year freedom from recurrence is approximately 10%. These results might suggest that surgery is not indicated for pleural dissemination of thymic carcinoma.