Objective To investigate and evaluate the clinical features, diagnostic methods, surgical management and postoperative adjuvant therapy of thymic carcinoma so as to improve the treatment outcome. Methods Forty-three patients of thymic carcinoma , surgically intervened and pathologically confirmed in Peking Union Medical College Hospital through June 1961 to June 2004, were retrospectively analysed. Complete resection of the tumor was performed in 15 patients, partial or incomplete expiration in 23 , exploratory thoracotomy and biopsy in 5. Results All tumors were found inencapsulated and invading the surroundings,including pericardium, superior vena cava, left or right innominate vein, rnediastinal pleura, phrenic nerve and lung. In this series there was no perioperative death. Eight patients died within the first year postoperatively, 4 died within the second year postoperatively, 2 and 1 patients died in the 5th and 8th year postoperatively respectively. Through half to 18 years follow-up, according to the life table method, the 1,3,5 and 8 year survival rate were 68.29%, 56. 67%, 41.56% and 27. 71% respectively. Conclusions Thymic carcinoma is different from malignant thymoma in clinical manifestations, radiological features, pathological characteristics and prognosis, hence it is very important for thoracic surgeons to pay more attention to those differentiation. Chest CT is an effective method for diagnosis of thymic carcinoma. It is emphasized on that aggressive radical resection of the tumor with involved tissue or organs, even removal of superior vena cava and subsequent reconstruction of vessel, will effectively extend long-term survival. Postoperative radiotherapy and combination adjuvant chemotherapy, especially based on cisplatin, play a significant role in improvement of prognosis.