1509PD - Quality of resection and outcome in stage III thymic epithelial tumors (TET): A retrospective analysis of 150 cases from the national network RYTHM...

Date 10 October 2016
Event ESMO 2016 Congress
Session Non-metastatic NSCLC and other thoracic malignancies
Topics Thymoma and Thymic Cancer
Presenter Maria Bluthgen
Citation Annals of Oncology (2016) 27 (6): 522-525. 10.1093/annonc/mdw391
Authors M.V. Bluthgen1, E. Dansin2, D. Ou3, H. Lena4, J. Mazieres5, E. Pichon6, F. Thillays7, G. Massard8, X. Quantin9, Y. Oulkhouir10, T. Nguyen Tan Hon11, L. Thiberville12, C. Clement-Duchene13, C. Lindsay1, P. Missy14, T. Molina15, N. Girard16, B. Besse1, P. Thomas17
  • 1Cancer Medicine, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 2Medical Oncology Department, Centre Oscar Lambret, Lille/FR
  • 3Department Of Radiation Oncology, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 4Medical Oncology Department, Centre Hospitalier Universitaire de Rennes, Rennes/FR
  • 5Medical Oncology Department, CHU Toulouse, Hôpital de Larrey, Toulouse/FR
  • 6Service De Pneumologie Et D'explorations Fonctionnelles, CHRU de Tours, Tours/FR
  • 7Service De Radiothérapie, ICO Institut de Cancerologie de l'Ouest René Gauducheau, St. Herblain/FR
  • 8Department Of Thoracic Surgery, C.H.U. Strasbourg-Nouvel Hopital Civil, Strasbourg/FR
  • 9Respiratory Disease Department, CHU Montpellier, Montpellier/FR
  • 10Service De Pneumologie Et Oncologie Thoracique, Hôpital de la Côte-de-Nacre, Caen/FR
  • 11Medical Oncology Department, Centre Francois Baclesse, Caen/FR
  • 12Medical Oncology Department, Rouen University Hospital, Rouen/FR
  • 13Chest Department, University Medical Center Nancy, Nanacy/FR
  • 14Epidemiology, Intergroupe Francophone de Cancérologie Thoracique, Paris/FR
  • 15Department Of Pathology, GH Necker - Enfants Malades, Paris/FR
  • 16Department Of Respiratory Medicine, Louis Pradel Hospital, Lyon/FR
  • 17Department Of Thoracic Surgery, Hôpital Nord-APHM, Marseille/FR

Abstract

Background

Stage III TET represents a heterogeneous population and their optimal approach remains unclear; most of the available literature is composed of small series spanned over extended periods of time. RYTHMIC (Réseau tumeurs THYMiques et Cancer) is a French nationwide network for TET with the objective of territorial coverage by regional expert centers and systematic discussion of patients management at national tumor board. We reviewed our experience in stage III thymic tumors in order to evaluate the value of tumor board recommendations and multidisciplinary approach.

Methods

We conducted a retrospective analysis of patients (pts) with stage III TET discussed at the RYTHMIC tumor board from January 2012 to December 2015. Clinical, pathologic and surgical data were prospectively collected in a central database. Survival rates were based on Kaplan-Meier estimation. Cox proportional hazard models were used to evaluate prognostic factors for disease free survival (DFS) and overall survival (OS).

Results

150 pts were included in the analysis. Median age was 64 years [18 – 91], 56% males, thymoma A-B2/ B3-thymic carcinoma in 52% and 47% respectively; 12% presented with autoimmune disorder (76% myasthenia). Local treatment was surgery in 134 pts (90%) followed by radiotherapy (RT) in 90 pts; 26 pts received preoperative chemotherapy (CT). Complete resection rate (R0) was 53%. Among 38 pts considered non-surgical candidates at diagnosis, 26 pts became resectable after induction CT with a R0 rate of 58%; 12 pts received CT-RT and/or CT as primary treatment. Recurrence rate was 38% (n = 57), first sites were pleural (n = 32) and lung (n = 12). The 5-year OS and DFS were 88% and 32% respectively. Gender (p = 0.04), histology (p = 0.02) and surgery (p 

Conclusions

Surgery followed by radiotherapy improves outcome irrespectively of R0. Stage III TET not candidate to surgery should be reassessed for resection after induction chemotherapy.

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

RYTHMIC

Disclosure

All authors have declared no conflicts of interest.