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Siddhartha Yadav



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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
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.15-08 - Association of Perioperative Chemotherapy with Survival in Thymic Malignancies (ID 1436)

      08:00 - 18:00  |  Author(s): Siddhartha Yadav

      • Abstract
      • Slides

      Background

      Patterns of perioperative chemotherapy utilization and its association with survival in thymic malignancies are largely unknown.

      Method

      We queried NCDB from years 2004-2014 and identified 3,788 patients with non-metastatic thymic carcinoma (TC) and thymoma who received surgery. We compared patients who received perioperative chemotherapy to those who didn't and used a Cox proportional hazards model to determine predictors of mortality.

      Result

      764 patients (20%) received chemotherapy: 287(38%) neoadjuvant (NAC), 347(45%) adjuvant (AC), and 130(17%) unspecified. 184(24%) had TC; the rest had thymoma. Patients who didn’t receive chemotherapy (N=3024) had older age (median 62 vs 47, P<0.01) and earlier stage (51% versus 24% stage I-IIA, P<0.01). In multivariable analysis, patients who received AC versus no chemotherapy had a similar overall survival(OS); however, NAC predicted a worse OS. For separate thymoma and TC subsets, median OS did not differ between those who received AC and those who didn’t in either group. AC did not improve OS for patients with R1/R2 margins (114 months, 95%CI 94-NR vs 131 months, 95%CI 118-NR)

      Characteristic

      Hazard ratio for mortality (95% confidence interval) 1

      Age

      1.03 (1.03-1.04)

      Thymoma vs. TC

      0.50 (0.43-0.58)

      Charlson-Deyo score>0

      1.40 (1.21-1.63)

      Chemotherapy

      None

      Adjuvant

      Neoadjuvant

      Unclassified

      1

      1.13 (0.89-1.44)

      1.77 (1.37-2.27)

      1.60 (1.16-2.19)

      Masaoka-Koga Stage

      I-IIA

      IIB

      III

      Unknown/other

      1

      1.08 (0.88-1.34)

      1.59 (1.34-1.90)

      2.71 (2.01-3.65)

      Radiation

      0.78 (0.67-0.91)

      Positive margin

      1.55 (1.33-1.81)

      1Model included sex, academic center, insurance, and race/ethnicity

      tc_surv_plot_stages_chemo_thymic_carcinoma.jpg

      tc_surv_plot_stages_chemo_thymoma.jpg

      Conclusion

      Chemotherapy in the perioperative setting was not associated with improved OS in either TC or thymoma. Prospective controlled studies are needed to determine the role of perioperative chemotherapy in thymic malignancies.

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