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Rita Barata
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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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EP1.15-15 - Single-Center Retrospective Analysis of Operated Thymomas (Now Available) (ID 2890)
08:00 - 18:00 | Author(s): Rita Barata
- Abstract
Background
Thymoma is the most common thymic neoplasm. In the majority of cases, patients are asymptomatic and the diagnosis is incidental. Surgery is the gold-standard treatment whenever possible. The objective of this study was to evaluate retrospectively the surgical outcomes in patients with stage Masaoka-Koga I to IVa thymomas at our department.
Method
A review of 50 cases of thymomas submitted to surgical excision at our Thoracic Surgery Department was made by accessing their clinical records, in a six-year period, from January 2012 to December 2018.
Result
From the 50 patients, 38% were males, with an average age of 58 years old, ranging from 15 to 85.
In a relatively high percentage of patients, the thymic malignancy was accidentally found in a CT-scan. 24 of the cases were associated with Myasthenia Gravis.
All the patients had a CT-scan prior to surgery but just 3 had done a PET-CT scan that seemed to be reserved to those of a higher stage.
The histological diagnosis was done by CT-controlled biopsy in 14 cases and in the rest the diagnosis was done by the analysis of the extracted specimen. There were 4 type A thymomas, 12 type AB, 5 type B1, 17 type B2, and 10 type B3, one sclerosing thymoma and one micronodular thymoma with lymphoid stroma. The majority (54%) were in Masaoka-Koga stage II. There were 11 patients at stage I, 9 at stage III and only 3 at stage IV.
Only 3 patients did neoadjuvant treatment, 21 patients had adjuvant radiotherapy, 2 patients had adjuvant chemotherapy and 3 had both.
The surgical approach was sternotomy in 76% of cases, videothoracoscopy in 18%, thoracotomy in 2%, sternotomy plus thoracotomy in 2%, hemiclamshell in 2%. In all cases was done an en bloc resection, which in some involved lung resection (16), pericardial resection (9), vascular resection (8) and diaphragm resection (1).
There was no surgical mortality, but 10 patients had phrenic nerve paralysis and 2 had a myasthenic crisis.
The mean of hospital stay was 7 days (+- 8), comprising between 2 and 56 days.
After a mean follow-up of 29 months (+- 20 months), there were 2 disease-related deaths and 4 recurrences (2 pleural, one diaphragmatic and one lung and mediastinal). The time to recurrence ranged from 4 to 74 months. There was a 100% survival rate at the post-operative period and overall survival at 5 years of 81%. Regarding the Masaoka classification, the 5-year-survival rate was shown to be of 100% in stage I, 96% in stage II, 44% in stage III and 100% in stage IV. On the other hand, the analysis by the WHO classification showed a 5-year-survival of 100% in thymoma A and AB groups, 40% in thymoma B1 group, 75% in thymoma B2 group and 67% in thymoma B3 group.
Conclusion
Even though thymic malignancies are rare tumors, thymomas are commonly approached by the Thoracic Surgeon. Surgical resection is the mainstay of treatment, but a multimodality approach is crucial in specific cases.
