Author of

• 25907

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  OA11 - Thymic and Other Thoracic Tumours: Targeted Therapies, Biomarkers and Neo/Adjuvant Radiotherapy (ID 919)

  • Event: WCLC 2018
  • Type: Oral Abstract Session
  • Track: Thymoma/Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 13:30 - 15:00, Room 205 BD

  • 26086

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    OA11.02 - A Population-Based Study of Incidence and Survival Trends of 1,588 Thymic Malignancies: Results from the California Cancer Registry (ID 12459)

    13:40 - 13:50  |  Author(s): Amy Klapheke
    • Abstract
    • Presentation
    • Slides

    Background
    

    Thymic malignancies (TM) are rare with sparse population-based epidemiologic literature. According to data collected by the National Cancer Institute from 1973 to 2006, the incidence of thymomas is 0.13 per 100,000 person-years in the United States.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We used data from the California Cancer Registry (CCR), a comprehensive population-based state registry to examine TM incidence and survival trends in California from 1988 to 2015. Cases were specified by site (thymus), histology (thymic carcinoma and thymoma), and behavior (malignant). Primary endpoints were cause-specific survival (CSS) and overall survival (OS). Age-adjusted incidence rates were calculated in SEER*Stat, and Joinpoint regression was used to analyze incidence trends. Hazard ratios (HR) for CSS and OS were calculated using a Cox proportional hazards regression model controlling for relevant baseline variables including age, gender, stage, and year of diagnosis, among others.

    4c3880bb027f159e801041b1021e88e8 Result
    

    We identified 1,588 TM cases in California from 1988 to 2015 with an annual percent increase of 2.08% (95% CI: 1.3%, 2.9%; p < 0.0001). The incidence of TM in 2015 was 0.277 per 100,000. Thymic carcinoma histology was associated with worse CSS across all stages, including localized (HR 7.56, 95% CI 1.44, 39.78), regional (HR 4.23, 95% CI 2.55, 7.01), and remote (HR 2.09, 95% CI 1.37, 3.19) disease. Compared to no treatment, surgery with or without radiation was associated with improved CSS in localized (surgery: HR 0.05 (95% CI 0.01 to 0.35), surgery + radiation: HR 0.12 (95% CI 0.02 to 0.84)) and regional disease (surgery: HR 0.11 (95% CI 0.04 to 0.29), surgery + radiation: HR 0.15 (95% CI 0.06 to 0.36)). Chemotherapy and radiation was also associated with improved CSS in regional disease (HR=0.22 (95% CI 0.07 to 0.63) and remote disease (5.16 (0.37, 71.94)), though the latter was not statistically significant.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    This is a population-based study of TMs from the CCR that identifies baseline variables significantly associated with CSS. TM incidence appears to be increasing over time. Advanced stage and thymic carcinoma were found to be associated with worsened CSS, which is consistent with previous studies. Treatment incorporating surgery was associated with improved CSS in local and regional disease, as was chemoradiation in regional disease. Improvement in CSS trended towards significance in patients with remote thymic neoplasms treated with chemoradiation. These findings provide a more contemporary database for future TM outcomes research.

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