Author of

• 10897

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  P1.15 - Poster Session 1 - Thymoma (ID 189)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Thymoma & Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10903

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    P1.15-006 - Thymic malignancies. A single institution series from 2000-2012 (ID 2287)

    09:30 - 16:30  |  Author(s): H. Jonker
    • Abstract

    Background
    Thymoma and thymic carcinoma are rare malignancies, despite being amongst the most common tumours of the anterior mediastinum. The incidence of thymoma in the United States is approximately 0.15 per 100,000 person years. Thymoma research has proved challenging, and as such the International Thymic Malignancy Interest Group (ITMIG) has created an international database in an effort to promote the advancement of clinical and basic science research in thymic malignancies. We performed a single institution retrospective chart review to submit to ITMIG, collecting additional data regarding systemic therapy regimens.

    Methods
    With ethics approval, we performed a retrospective chart review of all patients seen at our institution between January 2000 and December 2012 with a diagnosis of thymic neoplasm. Data collected included baseline patient demographics, histology (WHO), staging (Masaoka), the presence or absence of associated paraneoplastic syndromes such as myasthenia gravis (MG), treatment decisions and survival. All lines and indications of systemic therapy were recorded.. The primary analysis is descriptive.

    Results
    In total 76 patients were included; 35 female (46%); median age at diagnosis 60 years (range 25-89) and 71 (93%) had a good performance status (ECOG 0-1). MG was present in 16 (21%). The WHO histological classification was: A (11, 15%), AB (23, 30%), B1 (12, 16%), B2 (10, 13%), B3 (13, 17%), C (5, 7%), NETT (1, 1%), and unclassified (1, 1%). Definitive surgery occurred in 64 cases (84%), with an R0 resection in 53 patients. For those who had surgery, 11 also received chemotherapy either as induction (6), adjuvant (4) or both (1); 27 received radiotherapy either as induction (2) or adjuvant therapy (25). Twelve patients (16%) were not treated surgically, and three patients received no therapy at all. In total only 14 patients (18%) received systemic therapy in any setting. Where evaluable, the first-line RECIST response rate was 55%, but no patients had progressive disease (Figure). Common first-line regimens were platinum/etoposide (8), carboplatin/paclitaxel (3) and CAP (cyclophosphamide, adriamycin, cisplatin, n=2). Only 3 patients received further chemotherapy (1 patient received 2 further lines; 2 patients received 3 more lines). The median follow up for all patients was 45 months, and 59 (78%) remain alive. Of the 5 thymic carcinoma patients, 4 have died (median survival 10 months).

    Conclusion
    While few patients received systemic therapy for thymic malignancies, it remains a chemosensitive disease, but surgical resection is the mainstay of treatment.Figure 1