Author of

• 12751

  +

  P3.15 - Poster Session 3 - Thymoma (ID 192)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Thymoma & Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12754

    +

    P3.15-003 - Stage and presence of Myasthenia determine the recurrence free survival in thymoma: Single Institute experience (ID 2526)

    09:30 - 09:30  |  Author(s): R. Balakrishnan
    • Abstract

    Background
    In India, thymoma constitutes 0.1 to 0.2% of all malignancies whereas National Cancer Institute of USA reports 0.2 to 1.5%. The aim was to audit patients treated for thymomas and to associate various prognostic variables with survival and compare the same with western population studies to mark out any difference.

    Methods
    Retrospective review of 23 patients with thymoma treated from July 2008 to October 2012 was done. The various prognostic variables such as Mosaoka stage, WHO type, tumor size, extent of resection, presence of myasthenia gravis (MG), and treatment modalities were captured. Statistical analyses were done using SPSS and Kaplan-Meier method.

    Results
    The patients aged <50 years was 60.8% (n=14) with a male preponderance [73.9% (n=17)] and MG was present in 29.6% (n=8). Commonest stage at diagnosis was Mosoaka III-43.4% (n=12). Commonest type was WHO type AB and B2 [34.7% (n=8) in each]. Among patients who underwent surgery [91.3% (n=21)], either upfront or following neoadjuvant chemotherapy, R0 resection was in 47.8% (n=11), R1 in 30.4% (n=7), R2 in 13% (n=3) and only biopsy in 2 patients in stage IV. Postoperative radiation was given to 82.6% (n=19) when indicated (tumour more than 6 cm in stage I disease and adjuvant in stage II, III and IV). Conformal radiotherapy/IMRT was given in 60.8% (n=14). Chemotherapy with either platinum or anthracyclines or both given either as neoadjuvant, adjuvant or palliative in 56.5% (n=13) and second line chemotherapy with Docetaxel, Capecitabine, and or Everolimus was done for recurrence or progression. Three of 7 patients with MG who received radiotherapy had myasthenic crisis with treatment breaks. Three patients developed acute radiation pneumonitis, and 3 patients had associated pure red cell aplasia. With a median followup of 32 months (range: 3-66), recurrence rate was 26% (n=6) and OS 87%. The median time to recurrence or progression was 27 months (range: 1-66). In univariate analysis, the gender, presence of MG, stage, and extent of resection were significant prognostic factors for progression free survival. The presence of MG and stage were significant prognostic factors for overall survival.

    Variable	Disease free survival Mean (months)	Univariate (p value)	Overall survival Mean (months)	Univariate (p value)
    Age (years)		0.10		0.338
    <50 years	27.5		29.1
    >50 years	27.2		32.6
    Gender		0.003		0.067
    Male	30.17		33.7
    Female	19.5		21.3
    Myasthenia Gravis		0.002		0.031
    Present	25.8		26.1
    Absent	28.2		32.8
    Stage		0.001		0.008
    I AND II	20.1		21.5
    III AND IV	33.0		37.4
    EXTENT OF RESECTION		0.052		0.395
    R0	25.9		27.1
    R1	24.7		26.2
    R2	40.3		43.0
    Biopsy	25.5		45.0
    Tumor size		0.193		0.508
    <6 cm	29.7		34.6
    >6 cm	26.1		28.3

    Conclusion
    Compared to western population studies, our patients are younger, advanced stage at diagnosis and are with male preponderance. The influence of prognostic variables such as stage and presence of myasthenia and the progression free survival was comparable with that of published series. Our study could not demonstrate the extent of resection as a significant prognostic factor.