Abstract
7023 Background: The optimal approach to the management of thymoma and thymic carcinomas is unclear, particularly for advanced stage disease. Our primary study aim was to analyze treatment practices and outcomes in a population-based cohort of thymoma patients. Methods: All patients (pts) with a pathological diagnosis of thymoma or thymic carcinoma and referred to the British Columbia Cancer Agency (BCCA) between 1994 and 2009 were reviewed. Kaplan-Meier curves and Cox proportional hazard models were used to correlate histology, stage, and treatment with outcomes. Pathology review using WHO classification is currently underway. Results: 190 pts were identified of which 171 (90%) were referred to BCCA and eligible for analyses. Median was 60 years; 50% of pts were male. 26% had paraneoplastic phenomena; including 21% with myasthenia gravis.Pts with thymic carcinoma (n=23) and thymoma (n=148) had 5-year overall survival (OS) rates of 38% and 81%, respectively. Survival by stage is detailed in the table. Pts with stage I disease were treated primarily with surgery. Selected stage II pts received adjuvant radiation therapy, which conferred a significant improvement in progression free survival (98 vs. 62 months, p<0.01), but no OS benefit. There were practice variations in management of pts with advanced stage disease (n=71). A multimodality approach that included surgery, radiation, and chemotherapy correlated with better outcomes. Tri-modality treatment for thymoma achieved a 5-year OS of 85%; however, pts with advanced thymic carcinoma had poor outcomes despite aggressive treatment. In multivariate analyses histology (thymoma vs. thymic carcinoma) and surgery were significant predictors of OS. Conclusions: This study is the first population-based series to detail treatment and outcomes for thymoma. Outcomes compare favorably to series from single institutions. Pts with locally advanced disease for whom initial surgical resectibility is uncertain should be triaged to a multidisciplinary team for consideration of multimodality treatment. Five-year overall survival and progression-free survival. Stage 5 yr OS 5 yr PFS I (n=13) 91% 91% II (n=84) 86% 83% III (n=42) 70% 49% IV (n=32) 46% 13%
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
