167P - Role of surgery in the treatment of thymic carcinoma based on a 5-year experience

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Thymoma and Thymic Cancer
Lung and other Thoracic Tumours
Surgery and/or Radiotherapy of Cancer
Presenter Fatmir Caushi
Citation Annals of Oncology (2017) 28 (suppl_2): ii56-ii58. 10.1093/annonc/mdx093
Authors F.F. Caushi1, I. Skenduli1, J. Shkurti2, D. Xhemalaj1, A. Hatibi1, R. Kortoci1, B. Gega1, H. Hafizi1
  • 1Thoracic Surgery, University Hospital of Lung Disease "Shefqet Ndroqi", 12345 - Tirana/AL
  • 2Thoracic Surgery, University Hospital of Lung Disease "Shefqet Ndroqi", Tirana/AL

Abstract

Background

Invasive thymomas and thymic carcinomas are relatively rare neoplasms, which together represent about 0.2-1.5% of all malignancies. Thymic carcinomas account for only 0.06% of all thymic neoplasms and have extremely poor prognosis. In about 50% of the patients, thymic carcinomas are detected by chance with plain-film chest radiography. Nowadays the surgery is going to earn more and more space in their multimodality treatment because of new techniques and new technology.

Methods

We reviewed all cases with histologically confirmed thymic carcinoma treated between 2011 and 2016. This study was performed to investigate the tumor characteristics, treatment approach, and prognosis of patients with thymic carcinoma.

Results

There were 47% males and 53% females in this study. Mean age was 45,4 years. Thymic carcinoma was diagnosed in 13% of patients with mediastinal tumors, as opposed to 60% for thymoma. None of the thymic carcinoma patients had concomitant myasthenia gravis. All of the patients received surgical intervention and the diagnosis was made by pathologic study. The pathologic subtypes of thymic carcinoma included 40% squamous cell carcinomas, 35% undifferentiated carcinomas, 20% carcinoid tumors, and the rest other types of tumors. Surgery performed was en-bloc resection of the tumor in 22% of cases accompanied by partial resection of superior vena cava, total resection of the left innominate vein and partial pericardectomy, and debulking surgery in 18%. In all other cases surgery was undertaken for diagnostic purposes. No perioperative deaths occurred. All cases were treated postoperatively with adjuvant radio and/or chemotherapy. The mean of hospitalized days after surgery was 12±2.

Conclusions

Owing to the paucity of cases, optimal management of thymic carcinoma has yet to be defined, but one thing is for sure, that it requires multimodality treatment. Our experience supports the pivotal role of surgery in managing thymic carcinoma. En-bloc resection of the tumor is an essential treatment for favorable outcomes of locally advanced thymic tumors, while debulking surgery may be considered for patients in advanced stages because it minimizes the tumour size and area for irradiation postoperatively.

Clinical trial identification

Legal entity responsible for the study

Fatmir Caushi

Funding

Fatmir Caushi

Disclosure

All authors have declared no conflicts of interest.