EP1.15-21 Thymic Epithelial Tumors: Review of Clinical and Pathological Findings and Prognostic Factors for the Survival

Abstract

Considered as a very rare malignances (0,15 cases per 100.000), thymic epithelial tumors are also the most commun tumor of the anterior mediastinum. Their treatment is based on multidisciplinary management. The basis of the treatment is a complete surgical and carcinological resection. In locally advanced tumors, neo-adjuvant chemotherapy can be performed. In the case of invasive tumors or incomplete resection, adjuvant radiotherapy is usually recommended. We conducted a monocentric, descriptive and retrospective study based on the medical record of 32 patients who underwent surgery for a thymic epithelial tumors in the department of thoracic surgery in the university hospital Ibn Rochd, Casablanca, Morocco. The aim of this study is to review the clinical and pathological findings and also to determine which factors independently predict survival after surgical resection. The average age was 48 years and the sex ratio was 0. 88. Of the 32 cases, 32,4% had symptoms consistent with myasthenia gravis. Surgical resection was performed either by sternotomy, thoracotomy or VATS. It was complete in 87,5% of cases. 3 patients (9,4%) received neoadjuvant chemotherapy to reduce tumor size before the surgery. Post-operative radiotherapy was indicated in 31. 2% of patients. We have experienced only one death due to the disease in our series and 2 patients were lost to the follow-up. After an univariate analysis, prognostic factors were: the histological type, the Masaoka-Koga stage and the extent of surgical resection. No multivariate analysis could be done due to small numbers of patients. Thymic epithelial tumors present specific problems from anatomical pathology to therapeutic strategy. Their optimal care is still poorly defined because of their rarity and of the resulting difficulty to conceive large clinical trials. Meanwhile, ITMIG, UICC and AJCC are trying to develop a consensus on easier and more universal classification, based on the TNM, to help improve the management.