Abstract 145P
Background
TETs are rare, diverse cancers. Treatment variations and lack of consensus on follow-up strategies require real-world data for evidence-based guidelines.
Methods
We retrospectively analysed consecutive TET patients treated surgically from 2012 to 2022. Analysis included patient demographics, histological subtype, stage (International Association for the Study of Lung Cancer TNM 9th edition), treatment modalities, and recurrence patterns.
Results
The cohort comprised 198 patients with median age 64 (range 19-86), with balanced gender distribution. 17% had myasthenia gravis. The most common histological type was AB (28%). Thymoma types A and AB most commonly presented at early stage, B1 to B3 were more evenly spread across stages, while thymic carcinomas were mostly advanced at diagnosis. Neoadjuvant therapy was used in 34 patients, primarily in stages III-IV; four patients achieved complete pathological response, of whom two experienced subsequent recurrence. Complete resection was more achievable in early stages (stage I-II, 85%; stage III-IV, 44%). Stages III and IV required extensive surgeries, including pneumonectomy in 7, pleurectomy in 14, major vessel resection in 11, diaphragmatic resection in 10, and chest wall resection in 4. 27 (14%) had adjuvant radiotherapy, of whom 22 did not have clear margins. The 5-year overall survival (OS) was 89%, decreasing to 76% at 10 years. Recurrence occurred in 19 (9.6%), with the majority (11) being pleural and the highest rates noted in Type B3, followed by B2. Types A and AB had no recurrences. Seven were treated radically with further surgery or radiotherapy. Of those with recurrences, 6 are alive with disease, 6 are disease-free, and 7 died of disease.
Conclusions
This study highlights varied treatments and outcomes in TET management. Cases of (predominantly regional) recurrent disease underscore the need for vigilant follow-up, although this could potentially be relaxed in types A and AB given a better prognosis. Our experience shows surgery’s key role in advanced thymoma, leading to notable long-term survival despite surgical complexity. These findings emphasize tailored treatment strategies for improved TET patient outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S. Gennatas: Financial Interests, Personal, Invited Speaker, Presentations to health professionals: Amgen; Financial Interests, Personal, Invited Speaker, Presentation to health care professionals: Chugai. J. Spicer: Financial Interests, Institutional, Advisory Board, Compensation to my employer for time providing advice: AstraZeneca, BMS, GSK, RS Oncology; Financial Interests, Personal, Stocks/Shares, Co-founder: Epsilogen; Financial Interests, Personal, Stocks/Shares: Avacta; Financial Interests, Institutional, Invited Speaker, Reimbursement for treatment of patients in trial: Achilles, Roche, Starpharma, Trizell, BergenBio, BMS, IO Biotech, MSD, RS Oncology, Gilead, Iovance; Non-Financial Interests, Personal, Leadership Role, National strategy board: Experimental Cancer Medicine Centres; Non-Financial Interests, Personal, Member of Board of Directors, Steering Committee: British Thoracic Oncology Group; Non-Financial Interests, Personal, Advisory Role, Advice on licensing decisions for MHRA: CHM Expert Advisory Group on Oncology & Haematology; Non-Financial Interests, Personal, Advisory Role, Advice on regulatory approvals: CHM Cancer Vaccines Expert Working Group. A. Bille: Financial Interests, Personal, Advisory Role: Intuitive Robotic, BD. All other authors have declared no conflicts of interest.