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Benjamin Fels

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    P1.14 - Thymoma/Other Thoracic Malignancies (Not CME Accredited Session) (ID 946)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.14-21 - Circulating Biomarkers in Thymic Epithelial Tumors (ID 13914)

      16:45 - 18:00  |  Author(s): Benjamin Fels

      • Abstract


      Thymic epithelial tumors are the most common mediastinal tumors. Surgery is the mainstay of treatment and complete resection provides the best survival rate. Nevertheless, advanced tumors may require multimodal therapy and additional prognostic factors beyond tumor stage and histological classification might help to risk-stratify patients and personalize the treatment course.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Between 1999 and 2017 202 patients with thymic epithelial tumors were operated in our center. The preoperative C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels as well as clinical follow-up were retrospectively collected and the association of circulating biomarkers with clinicopathological parameters and their impact on overall survival was analyzed.

      4c3880bb027f159e801041b1021e88e8 Result

      115 male and 87 female patients were included in the study with 59.5 (±13.1) years mean age at the time of operation. 30 patients (including 12 male patients) suffered from myasthenia gravis. Thymic carcinoma was associated with high CRP (> 1mg/dl) when compared to thymoma cases (34% vs 12%, p=0.001). While LDH levels did not show such association, there was a strong tendency for increased mean LDH levels in Masaoka 4 patients (252.5±18.9 vs 220.5±6.1, p=0.063). Overall survival was analyzed in the thymic carcinoma subcohort. 90% of the patients were treated in a multimodal approach and received chemo- and/or radiotherapy in adjuvant or neoadjuvant setting. Median overall survival was 11.3 years. The Masaoka stage (1-3 versus 4) was a significant prognostic factor (HR 0.23, 95%CI 0.07 to 0.77, p=0.017). Elevated CRP (> 1mg/dl) did not show prognostic power for overall survival (HR 0.82, 95%CI 0.77 to 1.33, p=0.76). In contrast increased preoperative LDH level (>200 U/L) resulted in poorer outcome (HR 0.32, 95%CI 0.09 to 1.13, p=0.076).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Circulating biomarkers show association with advanced disease stage in thymic epithelial tumors. Importantly, preoperative LDH levels carry prognostic information in thymic carcinoma and could be used to risk stratify surgically treated patients in multimodal treatment settings.