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Patricia Rioja
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EP1.15 - Thymoma/Other Thoracic Malignancies (ID 205)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 2
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.15-28 - Survival of Thymoma Is Extensive in Latin-American Patients: Results from Over 10 Years of Experience (CLICaP-LATimus) (ID 2936)
08:00 - 18:00 | Author(s): Patricia Rioja
- Abstract
Background
Thymomas are a group of rare neoplasm of the anterior mediastinum. Due to their low incidence, large cooperative studies are required to evaluate outcomes. The objective of this study is to present the results and experience in treatment of this pathology in Latin-America.
Method
A retrospective multicenter cohort study was conducted by The Latin-American Consortium for the Investigation of Lung Cancer (CLICaP). Patients with histologically proven thymomas between 1997 and 2018 were included in the analysis. Variables including clinical, pathological and therapeutic outcomes were registered in a centralized manner.
Result
A total of 105 patients were included. Median age at diagnosis was 54 years old (20-84), and with 60% (n = 38) of the included patients were female. Only 11% (n=7) of the patients had an ECOG performance score >1. Twenty-four patients (22.9%, 95%CI 14.8-30.9) presented with pulmonary or distant metastatic involvement with a median of 2 metastatic sites. Furthermore, 21.9 % of patients (n=23, 95%CI 13.9-29.8%) concurrently presented myasthenia gravis. Surgery was performed in 55 patients (52.3%, 95%CI 42.8 – 61.9%), comprising of 15 tumorectomies, 37 thymectomies and 5 biopsies achieving an R0 resection rate of 78% (95%CI 67.3-89.1%). Adjuvant treatment in the form of either chemotherapy, radiotherapy or both was offered to 3(5%), 7(12.7%) and 5(9%) patients, respectively. Disease progression was documented in 10 cases (9%, 95%CI3.9-15.1%) of which 6 (60%) were locoregional, 1 (10%) distant progression and 3 (30%) both locoregional and distant. Median overall survival (OS) was estimated at around 139.5 months (95%CI 86.1-NA). Cox regression indicated that OS was significantly improved by resection (139.5 vs 25.7 months, HR 4.17 [95%CI 12.6-17.8 months]).
Conclusion
Survival in patients with thymomas continues to be very favorable, especially in patients who receive adequate local control. The benefit of adjuvant treatment in this setting remains unclear.
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EP1.15-29 - Real World Characterization and Treatment of Patients with Thymic Carcinoma: Lessons from a Latin-American Study (CLICaP-LATimus) (Now Available) (ID 2921)
08:00 - 18:00 | Author(s): Patricia Rioja
- Abstract
Background
Thymic carcinoma is a rare tumor that represents a clinical challenge, especially in resource limited settings. The objective of the present study was to characterize patients who presented this disease in Latin-America.
Method
From 2014 until 2018, a multinational Latin-American cooperative retrospective cohort study was performed. Patients with histologically confirmed thymic carcinoma were included. Clinical, pathological and treatment variables were collected across 7 participating nations.
Result
A total of 31 patients were included. Median age at diagnosis was 58 years old (34-69), 48% (n=15) of individuals were women with all but 2 patients (6.5%) achieving an ECOG performance score <2. All patients debuted with Stage IV disease; 24 patients (66%, [95%CI 62-92%]) as stage IVa and 7 as stage IVb (33%, [95%CI 7-37%]) with a median LDH level of 396.5 U/L (153-1529 U/L) and a median of 2 metastatic sites. 13 (41.9%, [95%CI 25-59%]) patients received preoperatory treatment consisting of chemotherapy (n=8, 42%) and chemoradiotherapy (n=5, 16%). Among these patients only 4 (12.9%) were subjected to surgery, two of which underwent a tumorectomy and 2 a thymectomy. 28 (90%, [95%CI 79.9-100%]) received palliative chemotherapy either with sunitinib (n=7, 25%) or cytotoxic agents. Median overall survival (OS) was reached at 20.2 months (95%CI 19-NA months). Patients who received preoperative treatment had a significantly prolonged OS (17.6 vs 26 months, HR 2.93 [95%CI 1.04-8.27 months], p = 0.03).
Conclusion
Thymic carcinoma constitutes an aggressive disease that is often diagnosed in advanced stages. These results suggest that multimodal treatment can be beneficial even in locally advanced cases. Larger clinical trial validating these conclusions are warranted.
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P2.15 - Thymoma/Other Thoracic Malignancies (ID 185)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.15-12 - Epidemiology of Thymic Epithelial Tumors: 22-Year Experience from a Single-Institution (ID 2831)
10:15 - 18:15 | Presenting Author(s): Patricia Rioja
- Abstract
Background
Thymic epithelial tumors (TETs) represents a heterogeneous group of rare neoplasms that represent, however, the most common entity of the anterior mediastinum. Epidemiological data and treatment options for these neoplasms are very limited.
Method
Retrospective study of TET diagnosed at Instituto Nacional de Enfermedades Neoplasicas (INEN) in Lima, Peru, from 1996 to 2018. Clinicopathological data was retrieved from clinical files. All cases were reviewed by a pathologist and reclassified according to the 2004 WHO classification system. Staging was performed with the Masaoka-Koga Staging System. Treatment and follow-up data were also collected. Survival curves were constructed with the Kaplan-Meier method.
Result
84 patients were included. Median age at diagnosis was 55 years old (range 19 to 84) and 51.8% were female. Most patients (95.2%) were in good status performance (Zubrod 0-2) and 36.5% were smokers. The histological type corresponded to thymoma (T) in 63.9% of cases (n=53) and to thymic carcinoma (TC) in 36.1% of cases. T were of type A, AB, B1, B2 and B3 in 15.8%, 19.7%, 3.2%, 3.9% and 7.9% of cases, respectively. The proportion of advanced disease (Masaoka stage III-IV) was higher in TC (89.6%) than in T (51.1%). The most common treatment modality was systemic chemotherapy for advanced disease in 37.3%. With a median follow-up of 88.4 months, median overall survival (OS) was 81.6 months for T and 12.3 months for TC (p=0.01). Survival according to different histological types is shown in table 1.
ConclusionHistological type
Median OS (months)
Thymoma A, AB, B1
102
Thymoma B2 – B3
16.7
Thymic carcinoma
12.3
The result of this study indicates a clear association between the WHO histological classification and Masaoka-Koga staging system with survival. We found a higher than expected proportion of T with advanced disease at diagnosis. The reasons behind this finding require further research. Being this a rare disease, collaboration is very important to foster knowledge and to promote prospective and randomized clinical trials focused on classification and treatment.
