Author of

• 11842

  +

  P2.15 - Poster Session 2 - Thymoma (ID 191)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Thymoma & Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11847

    +

    P2.15-005 - Long-term survival after the multimodal treatment of thymic carcinomas: A single center experiences in 90 cases. (ID 1245)

    09:30 - 09:30  |  Author(s): H.S. Jung
    • Abstract

    Background
    Thymic carcinomas are rare aggressive tumors. We reviewed our experiences to evaluate the long-term prognosis regarding the multimodal treatment of thymic carcinoma.

    Methods
    A retrospective analysis was made of a total number of 90 patients who diagnosed with thymic carcinomas between December 1997 and July 2012. Among patients, 33 patients were treated with surgical resection followed by radiotherapy with or without chemotherapy. Of the remaining 57 patients treated initially with chemotherapy with or without radiotherapy for advanced thymic carcinoma, 24 patients could have surgical resections. The survival rate was compared between the groups. Stage was measured according to the Masaoka-Koga system.

    Results
    The study group was composed of 57 men and 33 women, with a mean age of 51.5 (±1.2 years). At the time of diagnosis, 10 patients (11.1%) had stage I disease, 14 (15.6%) stage II, 21 (23.3%) stage III, and 45 (50.0%) stage IV. Histologic subtypes included 50 squamous cell carcinoma (55.6%), 10 poorly-differentiated neuroendocrine carcinoma (11.1%), 5 well-differentiated neuroendocrine carcinoma (carcinoid tumors, 5.6%), and 4 other types (4.4%) among 69 patients whose histologic classification were made by pathologic study. Overall survival rates were 55.1% at 5 years and 32.3% at 10 years. Five year survival rates were 100% in stage I or II, 68.8% in stage III, and 39.8% in stage IV (p=0.012). Five year survival rates of the patients had treated with complete resection, the patients with incomplete resection, and the patients with unresectable tumors were 95.0%, 84.4%, 10.4%, respectively (p<0.001). In regard to the role of chemoradiotherapy, the survival rate of 24 patients had treated with initial chemotherapy followed by surgical resection, consisted of 13 cases of complete resection and 11 cases of incomplete resection and 4 cases of exploration, was better than those of 33 patients who were received chemotherapy with or without radiotherapy alone (5 year survival rate, 84.8% vs. 10.4%, p<0.001). On multivariate analysis, the extent of surgical resection (complete resection vs. unresectable tumors: hazard ratio [HR] =0.117; 95% CI 0.038-0.365; p<0.001, incomplete resection vs. unresectable tumors: HR=0.200; 95% CI 0.075-0.536; p=0.001) was the sole independent prognostic factor in this study.

    Conclusion
    The prognosis of patients with thymic carcinoma is distinct according to the extent of surgical resection. Initial chemoradiotherapy followed by surgical resection may produce long-term survival even at advanced stages of disease. Surgical resection of regressed tumors at loco-regional disease after initial chemotherapy with or without radiotherapy should have attempted.