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Philip A. Haddad



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    P26 - Mesothelioma, Thymoma and Other Thoracic Malignancies - Thymic Malignancies (ID 218)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Mesothelioma, Thymoma and Other Thoracic Malignancies
    • Presentations: 3
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P26.01 - Survival Impact of Adjuvant Postoperative Radiation Therapy (PORT) in Locally Advanced Thymic Carcinoma (TC): An Up-To-Date Meta-Analysis (ID 1189)

      00:00 - 00:00  |  Presenting Author(s): Philip A. Haddad

      • Abstract
      • Slides

      Introduction

      TC is a rare malignancy that often carries a poor prognosis. Surgery remains the primary curative therapeutic approach when feasible with chemotherapy and/or PORT used as adjuvant modalities in an attempt to improve patients’ outcomes. Published comparative studies have reported conflicting results for PORT. The benefit of adding PORT to other adjuvant modalities in Masaoka-Koga stages II&III TC remains controversial. The purpose of this meta-analysis is to evaluate the impact of adding PORT to surgery with or without chemotherapy on overall survival (OS) in patients with resected Masaoka-Koga stages II&III TC.

      Methods

      A review of the medical literature was conducted using online databases. Inclusion criteria consisted of resected Masaoka-Koga stages II&III TC, English language, studies reporting OS with hazard ratios (HR) or Kaplan-Meier curves, and comparative studies reporting outcomes of patients that underwent PORT versus those that did not. Studies that combined stages II&III with other stages were allowed as long as the preponderance of the sample consisted mainly of stages II&III. Those that did not separate Thymoma and Thymic carcinoma were excluded. A meta-analysis was conducted using an inverse variance method with random-effects model.

      Results

      Eight retrospective series with a total of 4,321 patients were included and analyzed. Two studies reported data on stages II&III and one study reported on stages III&IV. Two studies reported data that included stages I through III and three studies reported data that included stages I through IV. The addition of PORT was found to significantly impact OS in patients with resected stage II&III TC (HR 0.78, 95%CI:0.68-0.88; I2=28%).

      Conclusion

      This is the first meta-analysis to show that adding PORT to adjuvant therapies is associated with a survival benefit in a cohort of resected TC with a preponderance of Masaoka-Koga stages II&III.

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      P26.02 - The Impact of Clinicopathologic Factors on the Overall Survival of Thymic Neuroendocrine Tumors (TNET): A Pooled Analysis (ID 1192)

      00:00 - 00:00  |  Presenting Author(s): Philip A. Haddad

      • Abstract
      • Slides

      Introduction

      TNET are very rare tumors with poor prognosis. Consequently, available studies lack the power to validate factors that influence long-term clinical outcomes. The purpose of this meta-analysis is to evaluate the pooled impact of selected clinicopathologic factors on overall survival (OS) in patients with TNET.

      Methods

      A review of the medical literature was conducted using online databases. Inclusion criteria consisted of TNET diagnosis, English language, and studies reporting OS with hazard ratios (HR) or Kaplan-Meier curves. Those that did not report TNET outcomes separately were excluded. A meta-analysis was conducted using an inverse variance method with a random-effects model.

      Results

      Seven retrospective series with a total of 819 patients were included and analyzed. Tumor grade, Ki67 >10%, size >7cm, and adjuvant radiation therapy did not have a significant impact on OS. However, female sex (HR 1.57, 95%CI:1.17-2.10), stage III&IV (HR 3.87, 95%CI:2.28-6.57), and surgical resection (HR 0.36, 95%CI:0.26-0.51) significantly impacted TNET OS.

      Conclusion

      This is the first meta-analysis to explore the impact of clinicopathologic factors on TNET OS. It indicates that surgical resection is associated with improved OS while female sex and advanced stages adversely impact TNET OS.

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      P26.03 - The Impact of Postoperative Radiation Therapy on the Overall Survival of Resected Stage II Thymoma: An Up-to-date Meta-Analysis (ID 1193)

      00:00 - 00:00  |  Presenting Author(s): Philip A. Haddad

      • Abstract
      • Slides

      Introduction

      The survival benefit of postoperative radiation therapy (PORT) in patients with completely resected Masaoka/Koga stage II Thymoma has been controversial. Two separate meta-analyses were conducted in 2015 and 2016 to address this uncertainty. The former revealed no survival benefit to PORT in stage II. However, the latter revealed an increased survival in a combined cohort of stages II & III. The purpose of this meta-analysis is to evaluate the impact of PORT on overall survival (OS) in patients with completely resected Masaoka/Masaoka-Koga stage II only Thymoma incorporating more recent studies.

      Methods

      A review of the medical literature was conducted using online databases. Inclusion criteria consisted of resected Masaoka/Koga stage II Thymoma, English language, studies reporting OS with hazard ratios (HR) or Kaplan-Meier curves, and comparative studies that reported OS data on patients that underwent PORT versus those that did not. Studies that combined stage II with other stages and those that combined Thymoma with Thymic carcinoma were excluded. A meta-analysis was conducted using an inverse variance method with a random-effects model.

      Results

      Seven retrospective series with a total of 2,828 patients were included and analyzed. Three of these studies analyzed their data using stage IIB as a separate category while the remaining 4 analyzed stage II as a whole. PORT was found to be significantly associated with OS benefit in patients with completely resected stage II Thymoma (HR 0.77, 95%CI:0.71-0.84; I2=0%).

      Conclusion

      This is the first meta-analysis to show that PORT is associated with a survival benefit in patients with completely resected Masaoka/Koga stage II Thymoma. In the absence of randomized clinical trials, it represents the most compelling data supporting the use of PORT in this patient population.

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