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Adnan Aydiner
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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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EP1.15-11 - Outcomes of Thymoma and Determinants of Survival: 16 Years Experience of a Tertiary Cancer Center (Now Available) (ID 1065)
08:00 - 18:00 | Presenting Author(s): Adnan Aydiner
- Abstract
Background
We aimed with this study to explore the demographics and clinical outcome of patients with thymoma.
Method
A total of 203 patients with thymoma (Masaoka stage II-IV) treated from 2002-2018 were included in this retrospective analysis. IBM-SPSS statistical software version 20 for Windows (IBM, NY) was used for analysis. Survival analysis were estimated by the Kaplan–Meier method and compared by the log-rank test. p<0.05 was considered statistically significant. Cox-regression tests used for multivariate analysis.
Result
Male:female ratio was 105:98 with median age 49 years (Range 11-77). At presentation, patients with stage II, III and IV disease were 90, 67 and 45, respectively. A total of 123 patients(60,6%) had myasthenia gravis, and 56,1% of these patients had presented with myasthenia related symptoms. Majority of the patients were operated with sternotomy(n=103), and mean hospital stay was 8,34 days (Table 1). A total of 76 patients had received adjuvant radiotherapy, and 31 patients and 35 patients had received adjuvant and neoadjuvant chemotherapy, respectively. At mean follow-up of 218,6 months(95%CI:201,8-235,3), 5-year and 10-year OS rates were 93,8% and 89,2%. 30 patients had recurrence after surgery, and 5-year and 10 year DFS rates were 76,5% and 68,3%. Masaoka-Koga stage(p<0.0001), postoperative hospital stay more than 10 days(p=0,004) and needing neoadjuvant chemotherapy(p=0,003) were significant effects on DFS. Among patients who had given neoadjuvant chemotherapy, comparing cisplatin with etoposide or doxorubicin based combinations did not change DFS(p=0,34) or OS (p=0,48). Adjuvant radiotherapy and chemotherapy also have no survival effect on DFS and OS. On univariate analysis, age(p=0.013), Masaoka-Koga stage(p=0.001), postoperative hospital stay more than 10 days(p=0,006) and having recurrence(p=0,013) were significant effects on OS. Stage (p=0,001) and age (p=0.007) retained its prognostic significance on multivariate analysis (Table 2).
Table1: Patient demographics and summary of the treatment approachs. Age n = 203
<=50
>50
111 (% 54,7)
92 (% 45,3)
Gender n = 203
Male
Female
105 (% 51,7)
98 (% 48,3)
Myasthenia Gravis n = 203
Yes
No
123 (% 60,6)
80 (% 39,4)
Acetylcholine Receptors n=123
Yes
No
113 (% 91,87)
10 (% 8,13)
Masaoka Stage of Thymoma
n = 202
II
III
IV
Unknown
90 (% 44,3)
67 (% 33)
45 (% 22,2)
1 (% 0,5)
Pathology n = 203
Type A
Type AB
Type B1
Type B2
Type B3
Mixed
Micronodular Thymoma
Unknown
15 (% 7,4)
20 (% 9,9)
40 (% 19,7)
67 (% 33,0)
32 (% 15,8)
25 (% 12,3)
1 (% 0,5)
3 (% 1,5)
Surgery type
VATS (Thoracoscopic)
Sternotomy
Thoracotomy
RATS
Inoperable
54 (% 26,6)
103 (% 50,7)
37 (% 18,2)
5 (% 2,5)
4 (%2)
Treatment Modality
Neoadjuvant Chemotherapy
Adjuvant Chemotherapy
Adjuvant Radiotherapy
35 (% 17,6)
31 (% 15,6)
76 (% 38,2)
Table 2: Five-year overall survival and recurrence-free survival estimates in patient subgroups 5-Year Survival Rate
OS
P
RFS
P
Age
≤50
%96,6 +/- 1,9
0,013
%77,8 +/- 4,5
0,510
>50
%84,2 +/- 4,7
%75 +/- 5,4
Gender
Male
%91,5 +/- 3,4
0,852
%76,5 +/- 5
0,687
Female
%90,9 +/- 3,3
%76,5 +/- 4,9
Masaoka stage
2
%96 +/- 2,3
0,001
%93,1 +/- 3
<0,001
3
%88,4 +/- 5
%77,8 +/- 6,4
4
%85,4 +/- 6,2
%42,1 +/- 8,8
Myasthenia Gravis
Yes
%93,1 +/- 2,6
0,648
%80 +/- 4
0,358
No
%87,3 +/- 5
%69,4 +/- 6,7
Diagnosed before 2008
Yes
%97,3 +/- 2,7
0,544
%80 +/- 6,8
0,247
No
%89,1 +/- 2,8
%75,4 +/- 4,1
Chemotherapy
No
Neoadjuvant
Adjuvant
%93 +/- 2,4
%86,9 +/- 7,2 %75 +/- 15,3
0,74
%86,4 +/- 3,2
%47,7 +/- 10
%21,8 +/- 13,4
<0,001
Radiotherapy Type
No
Neoadjuvant
Adjuvant
%90,3 +/- 3,3
%50 +/- 3,5 %93,5 +/- 3,2
0,588
%79,6 +/- 4,5
-
%74,9 +/- 5,5
0,436
Time of initiation of adjuvant therapy
Early
Late
%90,9 +/- 8,7
%89,1 +/- 6,1
0,867
%65,3 +/- 14,3
%72,8 +/- 8,5
0,853
Pathology Type
Type A
Type AB
Type B1
Type B2
Type B3
Mixed Hystology
%88,9 +/- 10
%100
%91,8 +/- 4,5
%93,2 +/- 3,9
%84,9 +/- 8,5
%85 +/- 7,7
0,506
%83,6 +/- 10,3
%87,1 +/- 8,6
%77,4+/- 7,1
%76,7 +/- 6,3
%77,8 +/- 9,3
%57,2 +/- 11,7
0,538
Hospitalisation Days
<10 days
%95,7 +/- 1,9
0,006
%87,1 +/- 3,1
0,004
>=10days
%78,9 +/- 7,2
%56,9 +/- 8,9
Recurrence
Yes
%88,9 +/- 6
0,013
NA
-
No
%91,7 +/- 2,6
NA
Conclusion
Masaoka-Koga clinical stage and age are the important prognostic factors predicting OS. Postoperative hospital stay is related to DFS and OS.
