Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
strong specificity detection in patients with NSCLC, while it also indicated
that the lower frequency in tumor tissue, the less possibility to be detected
in plasma.
Keywords: EGFR, Quantstudio 3D digital PCR, ctDNA, Ion Proton
POSTER SESSION 2 – P2.04: MESOTHELIOMA/THYMIC
MALIGNANCIES/ESOPHAGEAL CANCER/OTHER THORACIC
MALIGNANCIES
Thymic Malignancies Clinical & Translational –
TUESDAY, DECEMBER 6, 2016
P2.04-001 A COMPARATIVE ANALYSIS OF LONG-TERM OUTCOME
OF THYMOMA BETWEEN VIDEO-ASSISTED SURGERY AND OPEN
RESECTION FROM MULTI-CENTER STUDY DATA
Su Kyung Hwang 1 , Dong Kwan Kim 1 , Chang Hyun Kang 2 , Chang Young Lee 3 ,
Jong Ho Cho 4
1 Department of Thoracic and Cardiovascular Surgery, Asan Medical Center,
University of Ulsan College of Medicine, Seoul/Korea, Republic of, 2 Thoracic and
Cardiovascular Surgery, Seoul National University Hospital, Seoul/Korea, Republic
of, 3 Yonsei University College of Medicine, Seoul/Korea, Republic of, 4 Thoracic &
Cardiovascular Surgery, Samsung Medical Center, Seoul/Korea, Republic of
Background: To compare the oncologic results between video-assisted
thoracoscopic surgery and open resection in early and locally advanced
thymomas from multi-center study database using propensity score matching
analysis. Methods: Data from 1546 participants in the Korean Association
for Research on the Thymus were used to analysis for video-assisted
thoracoscopic surgery(VATS) versus open resection from January 2003 to
December 2013. We performed propensity score matching analysis for the
outcomes of video-assisted thoracoscopic surgery versus thoracotomy lung
resection (based on age, gender, MG symptom, tumor size, WHO histologic
type, receiving neoadjuvant chemotherapy). Results: We excised the
thymoma using VATS in 513 patients, while 1033 patients underwent open
procedures. There were not significant differences between the 2 groups
for the 5-year overall survival (p=.61), recurrence-free survival (p=.25),
and complete resection (p=.38). The operative times, the hospital stay
duration, and the chest tube indwelling time were significantly shorter in
the VATS group compared to in the open group. Median follow-up duration
was 50.13 months (IQR 26.61-79.60). The Masaoka-Koga stage was I/II/
III, IV in 556/604/384 patients, respectively. We analyzed on the basis of
propensity score matching. There were no significant difference in survival
rate (p=0.882/0.632/0.597), recur-free survival (p=0.120/0.104/0.488), and R0
resection (p=0.945/0.656/0.007) between 3 grups in multivariable analysis.
Conclusion: Patients undergoing VATS thymectomy had shorter the operative
time and the hospital stay duration. Moreover, survival rate and recurrencefree
survival are equivalent between VATS and open resection. Therefore,
video-assisted thoracosopic surgery is feasible approach for early and locally
advanced stage thymoma.
Keywords: minimal invasive surgery, Thymoma, Thymic carcinoma
POSTER SESSION 2 – P2.04: MESOTHELIOMA/THYMIC MALIGNANCIES/ESOPHAGEAL
CANCER/OTHER THORACIC MALIGNANCIES
THYMIC MALIGNANCIES CLINICAL & TRANSLATIONAL –
TUESDAY, DECEMBER 6, 2016
P2.04-002 THE EFFICACY OF POSTOPERATIVE RADIOTHERAPY
AGAINST THYMIC EPITHELIAL TUMORS ACCORDING TO MASAOKA
STAGING AND WHO CLASSIFICATION
Kai Obayashi, Kimihiro Shimizu, Toshireru Nagashima, Yoichi Ohtaki, Seshiru
Nakazawa, Yoko Azuma, Misaki Iijima, Takayuki Kosaka, Toshiki Yajima, Akira
Mogi, Hiroyuki Kuwano
Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma
University Hospital, Maebashi/Japan
Background: Postoperative radiotherapy (PORT) against thymic epithelial
tumors is mainly performed based on Masaoka staging. However there is no
definite indication for PORT, and its efficacy is still controversial. Meanwhile,
the relationship between the efficacy of PORT and WHO classification is
also unclear. This study aimed to clarify the efficacy of PORT in association
with both Masaoka staging and WHO classification. Methods: A 262 patients
with thymic epithelial tumors surgically treated in our institute from April
1990 to December 2015 were reviewed. The clinicopathological data were
retrospectively evaluated for prognosis and recurrence. Results: There were
86 patients with stageI, 121 with stageII, 35 with stage III, 13 with stage IVa,
and 7 with stage IVb thymic epithelial tumors according to Masaoka staging.
As for histological type, 37 patients had type A, 50 had type AB, 59 had type
B1, 43 had type B2, 44 had type B3, and 29 had type C (thymic carcinoma)
according to WHO classification (2004). Eighty cases (30.5%) underwent
PORT. Although PORT showed no association with OS (hazard ratio [HR],
0.565; 95% confidence interval [CI], 0.298 to 1.070; p=0.080), there was no
recurrence in patients who received PORT. Subgroup analysis of Masaoka
staging (stageI-II: HR, 2.445; 95% CI, 0.905-6.607; p=0.078, stage III-IV: HR,
0.434; 95% CI, 0.145 to 1.302, p=0.137,) or WHO classification (type A-B1: HR,
2.859; 95% CI, 1.050-7.719, p=0.030, type B2-C: HR, 1.460; 95% CI, 0.502 to
4.248; p=0.488) alone showed no association with prognosis either. However
in thymoma patients who were classified in both stageIII-IV and type B2-C
group, PORT was associated with better OS (HR, 0.189; 95% CI, 0.049 to 0.724;
p=0.015). Conclusion: PORT is effective in patients with thyimic epithelial
tumors who are classified in both stageIII-IV and type B2-C.
Keywords: postoperative radiotherapy, WHO Classification, thymic epithelial
tumor, Masaoka staging
POSTER SESSION 2 – P2.04: MESOTHELIOMA/THYMIC MALIGNANCIES/ESOPHAGEAL
CANCER/OTHER THORACIC MALIGNANCIES
THYMIC MALIGNANCIES CLINICAL & TRANSLATIONAL –
TUESDAY, DECEMBER 6, 2016
P2.04-003 CHEMOTHERAPY IN ADVANCED THYMIC EPITHELIAL
TUMORS: INSIGHTS FROM THE RYTHMIC PROSPECTIVE COHORT
Claire Merveilleux Du Vignaux 1 , Maria Bluthgen 2 , Laurent Mhanna 3 , Eric
Dansin 4 , Laurent Greillier 5 , Eric Pichon 6 , Hervé Léna 7 , Christelle Clément-
Duchêne 8 , Gilbert Massard 9 , Virginie Westeel 10 , Marie Robert 11 , Xavier
Quantin 12 , Gérard Zalcman 13 , Luc Thiberville 14 , Thierry Molina 15 , Julien
Mazieres 3 , Benjamin Besse 16 , Nicolas Girard 17
1 Hospices Civils de Lyon, Lyon/France, 2 Gustave Roussy, Villejuif/France,
3 University Hospital, Toulouse/France, 4 Cancer Center, Lille/France, 5 University
Hospital, Marseille/France, 6 University Hospital, Tours/France, 7 University
Hospital, Rennes/France, 8 Cancer Center, Nancy/France, 9 University Hospital,
Strasbourg/France, 10 University Hospital, Besançon/France, 11 Cancer Center,
Nantes/France, 12 University Hospital, Montpellier/France, 13 University Hospital
Bichat, Paris/France, 14 University Hospital, Rouen/France, 15 University Hospital
Necker, Paris/France, 16 Department of Cancer Medicine, Gustave Roussy, Villejuif/
France, 17 Thoracic Oncology, Hospices Civils de Lyon, Lyon/France
Background: Thymic Epithelial Tumors (TET) are rare intrathoracic
malignancies, which may be aggressive and difficult to treat. In the advanced
setting, chemotherapy may be delivered as a primary/induction therapy
before subsequent surgery or definitive radiotherapy, and/or as exclusive
treatment in patients for whom no focal treatment is feasible, and/or in
the setting of recurrences. As no randomized trial and a limited number of
prospective studies are available, there is paucity of prospective, multicentre
evidence regarding response rates and survival of patients. RYTHMIC
is the nationwide network for TET in France. The RYTHMIC prospective
database is hosted by the French Intergroup (IFCT), and collects data
for all patients diagnosed with TET, for whom management is discussed
at a national multidisciplinary tumor board (MTB) based on consensual
recommendations. Primary, exclusive chemotherapy, and chemotherapy for
recurrence accounted for 149 (11%), 37 (3%), and 67 (5%) questions of a total
of 1401 questions raised at the MTB between 2012 and 2015. Methods: All
consecutive patients for whom chemotherapy and/or systemic treatment
was discussed at the RYTHMIC MTB from 2012 to 2015 were identified from
the RYTHMIC prospective database. Main endpoints were response rates and
progression-free and overall survival. Results: At the time of analysis, data
were available for 156 patients (80 thymic carcinomas, and 76 thymomas),
for whom the management led to raise 283 questions at the MTB: 67 (24%)
for primary chemotherapy, 35 (11%) for exclusive chemotherapy, and 181
(64%) for recurrences. For primary and exclusive chemotherapy, the most
frequently administered regimen was CAP, producing response rates of 70%
and 60%, respectively. A total of 104 patients received at least one line of
chemotherapy for recurrence; 53 patients received second-line treatment,
and 13 and 7 patients received third- and fourth line treatment. In the setting
of first recurrence, carboplatine-paclitaxel combination was the most
preferred regimen, administered to 54% of patients; overall response and
disease control rates to systemic treatments for recurrences were 13% and
42% in thymic carcinomas, and 19% and 43% in thymomas (p=0.38 and p=0.92,
respectively). Median recurrence-free survival after primary chemotherapy
was 16.6 months; median progression-free survival after exclusive
chemotherapy, and first-, second-, and third-line chemotherapy for recurrence
were 6.0 months, and 7.6 months, 6.2 months, and 6.0 months. Conclusion:
Our data provide with a unique insight in the efficacy of chemotherapy for
advanced thymic epithelial tumors in a real-life setting; our results help the
decision-making to better define the optimal therapeutic strategies.
Keywords: chemotherapy, Thymoma, Thymic carcinoma
Copyright © 2016 by the International Association for the Study of Lung Cancer
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