Quality of resection and outcome in stage III thymic epithelial tumors (TET): A retrospective analysis of 150 cases from the national network RYTHMIC experience

Date

10 Oct 2016

Session

Non-metastatic NSCLC and other thoracic malignancies

Presenters

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

Author affiliations

  • 1 Cancer Medicine, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 2 Medical Oncology Department, Centre Oscar Lambret, Lille/FR
  • 3 Department Of Radiation Oncology, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 4 Medical Oncology Department, Centre Hospitalier Universitaire de Rennes, Rennes/FR
  • 5 Medical Oncology Department, CHU Toulouse, Hôpital de Larrey, Toulouse/FR
  • 6 Service De Pneumologie Et D'explorations Fonctionnelles, CHRU de Tours, Tours/FR
  • 7 Service De Radiothérapie, ICO Institut de Cancerologie de l'Ouest René Gauducheau, St. Herblain/FR
  • 8 Department Of Thoracic Surgery, C.H.U. Strasbourg-Nouvel Hopital Civil, Strasbourg/FR
  • 9 Respiratory Disease Department, CHU Montpellier, Montpellier/FR
  • 10 Service De Pneumologie Et Oncologie Thoracique, Hôpital de la Côte-de-Nacre, Caen/FR
  • 11 Medical Oncology Department, Centre Francois Baclesse, Caen/FR
  • 12 Medical Oncology Department, Rouen University Hospital, Rouen/FR
  • 13 Chest Department, University Medical Center Nancy, Nanacy/FR
  • 14 Epidemiology, Intergroupe Francophone de Cancérologie Thoracique, Paris/FR
  • 15 Department Of Pathology, GH Necker - Enfants Malades, Paris/FR
  • 16 Department Of Respiratory Medicine, Louis Pradel Hospital, Lyon/FR
  • 17 Department Of Thoracic Surgery, Hôpital Nord-APHM, Marseille/FR
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Resources

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.

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