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Varas Kaewchoung



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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: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.15-02 - Thymic Epithelial Neoplasm: A 15-Year Experience Treatment in Rajavithi Hospital, Thailand (Now Available) (ID 583)

      08:00 - 18:00  |  Author(s): Varas Kaewchoung

      • Abstract
      • Slides

      Background

      Due to the rarity and indolent natural history of thymic tumors, the prospective randomized trials have been lacking. Surgery is the primary treatment for localized disease and chemotherapy may be indicated in advanced disease. We performed a retrospective review of all cases over a 15-year period at our institution.

      Method

      We retrospectively evaluated all patients who were diagnosed as thymoma and thymic carcinoma during 2003-2017 at Rajavithi hospital. Clinical characteristics, staging, treatment, and outcomes were collected and analyzed.

      Result

      Thymic epithelial neoplasms were identified in 60 patients: 52.0% male with a median age 56.5 years (range, 22-83 years), 87.0% with Eastern Cooperative Oncology Group performance status of 0 to 1. Paraneoplastic syndromes were presented in 21.7%. The distribution by WHO histologic classification was A, 3.3%; AB, 8.3%; B1, 25.0%; B2, 15.0%; B3, 15.0%; C, 1.7%; and thymoma unclassified, 31.7%. The majorities (55%) of patients were stage 1-3. Of 40 patients who underwent operation, 47.5% underwent R0 resection. Nineteen patients received adjuvant radiation and 5 patients received adjuvant chemotherapy. Palliative chemotherapy and radiation were given in 12 and 7 patients, respectively. The overall response rate to palliative chemotherapy was 10/12 (83.3%) with majority (75.0%) of patients received carboplatin plus paclitaxel.

      After a median follow-up of 26.8 (1-180) months, 53 (88.3%) patients remain alive. Median overall survival (OS) was 79.6 months with OS rate at 5-year being 73.6%. Ability to received surgical resection was the only significant (p = 0.003) prognostic factor on multivariate analysis.

      Figure Kaplan-Meier curve for overall survival in thymic malignancy patients (N=60), comparison by the ability to receive surgical treatment

      km curve for surgery in thymic tumors.jpg

      Conclusion

      Although surgical resection is the mainstay of treatment, it remains clear that these tumors are chemo-sensitive diseases. Traditional cytotoxic agents remain the standard of care in patients with advanced disease. Multidisciplinary approach should be offered in all patients.

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