Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
grading was WHO B3 (33%) followed by AB (25%). 58% had surgical margins < 1
mm, with tumour at margin in 24%. 39 patients (51%) had adjuvant
radiotherapy, with median follow-up of 5.1 years for these patients. A
radiotherapy dose of 45 – 50.4 Gy in 1.8 Gy fractions was used. 5-year survival
for the whole cohort was 68% after surgery alone, and 86% with adjuvant
radiotherapy, but the difference was not statistically significant. There were
no deaths during follow-up in patients who had clear surgical margins, with or
without radiotherapy. If surgical margins < 1 mm, there was a trend towards
improved overall survival with adjuvant radiotherapy (5-year survival 88%),
compared to surgery alone (5-year survival 50%) (log-rank test chisquare 3.7, p
= 0.056) (Fig. 1).
Conclusion: Thymomas had a significantly better prognosis than thymic
carcinomas suggesting that these are 2 different disease processes. The
variability in treatments received reflects the lack of information and general
consensus. Given the rarity of these tumours, greater emphasis must be
placed on collaborative efforts, to increase patient numbers and obtain
meaningful results that will increase our understanding of this challenging
group of patients and improve outcomes.
Keywords: Thymoma, Thymic carcinoma
Conclusion: The long-term outcomes of thymic epithelial tumours are
excellent after complete surgical excision. There is a trend towards improved
overall survival with adjuvant radiotherapy in patients with surgical margins
less than 1 mm. Routine referral of patients with close surgical margins for
consideration of radiotherapy is recommended.
Keywords: Radiotherapy, Thymoma, thymectomy
POSTER SESSION 2 – P2.04: MESOTHELIOMA/THYMIC MALIGNANCIES/ESOPHAGEAL
CANCER/OTHER THORACIC MALIGNANCIES
THYMIC MALIGNANCIES CLINICAL & TRANSLATIONAL –
TUESDAY, DECEMBER 6, 2016
P2.04-011 TUMOURS OF THE THYMUS: NORTHERN IRELAND 11
YEAR EXPERIENCE
Anastasia Papafili 1 , Lynn Campbell 2 , Rosie Douglas 1
1 Northern Ireland Cancer Centre, Belfast City Hospital, Belfast/United Kingdom, 2 Ni
Cancer Centre, Belfast City Hospital, Belfast/United Kingdom
Background: Tumours of the thymus are rare and consensus on their
management is lacking. We aimed to assess outcomes of patients diagnosed
over the last 11 years. Methods: We identified all patients diagnosed with
thymic tumours in Northern Ireland between January 2004 and December
2015 as recorded in the Cancer Registry. Electronic Care Records were used for
data collection. Results: Fifty-seven patients were identified, including 9
thymic carcinomas, 44 thymomas, 3 neuroendocrine tumours and 1 with small
cell features. Mean age at diagnosis was 62 (16-82) and 26% presented with
paraneoplastic phenomena. Of the thymoma patients, the majority presented
with early stage disease (45.5% stage 1, 31.8% stage 2) and 86% had surgery.
Ten patients received adjuvant radiotherapy (XRT), most received 50G in 20
fractions (#). Of those with advanced disease, only 3 received palliative
chemotherapy. Various platinum-based regimes were used. Only 1 patient
received any subsequent line of therapy. Generally thymic carcinomas
presented later, with > 75% with stage 3 or 4 disease. Despite this, almost half
(4/9) had surgery. Additionally, 2 received adjuvant XRT (between 40-50Gy)
and 1 adjuvant chemoradiotherapy (Cisplatin/Etoposide, 50Gy 25#). 44.4% of
these patients received palliative platinum-based chemotherapy, achieving
modest partial responses at best. Median overall survival (OS) for thymoma
(1) was 9.2 years compared to 6.2 years for thymic (2) carcinoma (p= 0.036)
POSTER SESSION 2 – P2.04: MESOTHELIOMA/THYMIC MALIGNANCIES/ESOPHAGEAL
CANCER/OTHER THORACIC MALIGNANCIES
THYMIC MALIGNANCIES CLINICAL & TRANSLATIONAL –
TUESDAY, DECEMBER 6, 2016
P2.04-012 A RISK OF DEATH FROM A SECOND CANCER FOLLOWING
COMPLETE RESECTION OF THYMOMA
Masatsugu Hamaji, Kyoko Hijiya, Hideki Motoyama, Toshi Menju, Akihiro
Aoyama, Toshihiko Sato, Fengshi Chen, Makoto Sonobe, Hiroshi Date
Kyoto University, Kyoto/Japan
Background: A portion of patients undergoing complete resection of
thymoma develop recurrence of thymoma, while those undergoing
thymectomy for thymoma are at risk of developing a second cancer, but it
remains unknown whether those patients are more at risk of death from
thymoma or from a second cancer. Methods: Retrospective chart review was
performed on our prospectively maintained database of patients undergoing
complete resection of thymoma at our institution between 1991 and 2016.
Thymoma-specific survival was calculated from thymectomy to death of
recurreence of thymoma. Second cancer-specific survival was calculated from
thymectomy to death of a second cancer. Both were estimated with Kaplan-
Meier method. Results: Follow-up ranged from 1 to 239 months (median: 54).
One hundred and sixty-four patients were identified. During the follow-up,
there were four thymoma deaths and 4 deaths from a second cancer. Five-year
and 10-year thymoma specific survival was 97.8% and 96.1%, respectively.
Five-year and 10-year second cancer specific survival was 98.2% and 96.1%,
respectively. Conclusion: It appears that patients undergoing thymectomy
for thymoma are at a similar risk of a second cancer death to that of thymoma
death. However, there are too few events during the follow-up and a multiinstitutional
database is required to more rigorously evaluate both risks.
Keywords: Thymoma, survival, a second cancer
POSTER SESSION 2 – P2.04: MESOTHELIOMA/THYMIC MALIGNANCIES/ESOPHAGEAL
CANCER/OTHER THORACIC MALIGNANCIES
THYMIC MALIGNANCIES CLINICAL & TRANSLATIONAL –
TUESDAY, DECEMBER 6, 2016
P2.04-013 PROGNOSIS FACTORS AND SURVIVAL ANALYSIS IN
THYMIC EPITHELIAL TUMORS
Luis Del Carpio 1 , Margarita Majem 2 , Laura López 3 , Josep Belda 4 , Elisabeth
Martínez Tellez 4 , Joan Carles Trujillo 4 , Alfons Torrego 3 , Virginia Pajares 3 , Núria
Farré 3 , Enrique Lerma 3 , Valle Camacho 3 , Alejandro Fernandez 3 , Ana Muñoz 3 ,
Georgia Anguera 1
1 Medical Oncology, Hospital de La Santa Creu I Sant Pau, Barcelona/Spain, 2 Medical
Oncology, Hopital de La Santa Creu I Sant Pau, Barcelona/Spain, 3 Hospital de La
Santa Creu I Sant Pau, Barcelona/Spain, 4 Thoracic Surgery, Hospital de La Santa
S526 Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017