166P - Thymoma and thymic carcinoma: A real-life retrospective analysis

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Thymoma and Thymic Cancer
Lung and other Thoracic Tumours
Presenter Ilaria Attili
Citation Annals of Oncology (2017) 28 (suppl_2): ii56-ii58. 10.1093/annonc/mdx093
Authors I. Attili1, S. Frega2, A. Pavan1, G. Pasello1, V. Polo1, G. Zago1, F. Rea3, F. Calabrese4, P. Conte5, L. Bonanno1
  • 1Medical Oncology 2, Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT
  • 2Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova/IT
  • 3Thoracic Surgery,cardiothoracic And Vascular Sciences, Università degli studi di Padova, Padova/IT
  • 4Cardiothoracic And Vascular Sciences, Università degli studi di Padova, Padova/IT
  • 5Surgery, Oncology And Gastroenterology, Università degli studi di Padova, Padova/IT

Abstract

Background

Thymic epithelial tumors (TETs) include thymoma and thymic carcinoma, a group of rare and heterogeneous thoracic cancers. The management is primarily surgical, but pre- and post-operatory chemotherapy and radiotherapy are to be evaluated. Recurrences after surgery occur in 10-15% of resected tumors.

Methods

We retrospectively collected TETs consecutively treated at our center between 2005 to 2016 and analyzed clinical and pathological features, response to treatment and patterns of relapse. Patients with uncomplete records or with less than 12-month follow-up were excluded from survival analysis.

Results

Study population included 57 TETs. Median age was 55 years, male: female ratio was 1:1, all were ECOG PS 0-1 at diagnosis. Histologic subtype A to B1 thymoma was 21%, B2-B3 47.4%, thymic carcinoma 21%, others 11%. Paraneoplastic syndromes were present at diagnosis in 1/3 of the cases (85% myasthenia gravis), mainly less differentiated histologies (85% B2 thymoma or higher). C-kit immunohistochemistry has been evaluated only in 30 cases, 1/3 resulting positive, 80% associated to thymic carcinoma. 50 cases were included in survival analysis: median follow up was 52 months (m) (95%CI: 30-74m), median overall survival (OS) has not been reached (121m- NA) and was not affected by recurrences (p: 0.34). Treatments and relapse patterns are summarized in table. 66% of patients developed disease relapse (51% pleura) regardless of histology and radical surgery, median time to first relapse was 30 m (95% CI: 6-54m), median OSr (OS from first relapse) was not reached (47m-NA) and was significantly worse for thymic carcinomas (p: <0.0001); OSr was not affected by treatment type, number or site of relapse; the only variable able to affect time to relapse was histology: ῃ2 0.27.rnTable: 166P

Treatment and relapse patterns in TETs [s: surgery; rt: radiotherapy; c: combined; r: relapse]

rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn
rnLocal treatment (s: rt: c)Systemic treatmentSystemic+ Local (s: rt: c)Best supportive care
1st diagnosis (N:57)27 (12: 0: 15)327 (8: 4: 15)0
1st r (N:33)14 (5: 2: 7)106 (1: 2: 3)3
2nd r (N:17)9 (6: 1: 2)53 (1:1: 1)0
3rd r (N:9)1 (1: 0: 0)51 (0: 0: 1)2
4th r(N:4)1 (0: 0: 1)11 (0: 0: 1)1
TOT5224386
rn

Conclusions

Real-life management of TETs include multidisciplinary evaluation, which is essential also at relapse to integrate local and systemic treatment.

Clinical trial identification

Legal entity responsible for the study

Istituto Oncologico Veneto

Funding

Istituto Oncologico Veneto

Disclosure

All authors have declared no conflicts of interest.