Thymic carcinoma: A cohort study of prognostic factors after surgical resection from the European Society of Thoracic Surgeons database.

Konference: 2013 49th ASCO Annual Meeting - účast ČR

Kategorie: Zhoubné nádory plic a průdušek

Téma: Lung Cancer - Non-small Cell Local-regional/Small Cell/Other Thoracic Cancers

Číslo abstraktu: 7602

Autoři: Enrico Ruffini; Frank C. Detterbeck, MD, FACS, FCCP; Dirk Van Raemdonck, MD, PhD, FETCS; Dr. Gaetano Rocco, FRCSEd; Pascal Alexandre Thomas; Prof. Dr. Walter Weder, FRCS; MD Alessandro Brunelli; Francesco Guerrera; Shaf Keshavjee; MD Nasser K. Altorki; Prof. MUDr. Jan Schützner, CSc.; Prof. Dr. Alper Toker; Lorenzo Spaggiari; MD Alex Arame, PhD; Eric Kian Saik Lim, MB, ChB, MSc, MD, FRCS(C-Th); Prof. Federico Venuta

Plný text abstraktu(odkaz vede na stránky ASCO)

Abstrakt byl publikován rovněž v Supplementu časopisu
J Clin Oncol 31, 2013 (suppl; abstr 7602)


Background: Thymic carcinomas are rare tumors which have recently been separated from thymomas due to their different histologic/clinical characteristics. Most of the current literature is composed of small series spanned over extended time periods Methods: The European Society of Thoracic Surgeons (ESTS) developed a retrospective database collecting data on patients with thymic tumors submitted to surgery (1990-2011). Out of 2,265 incident cases, there were 229 thymic carcinomas. Clinical-pathologic characteristics were analyzed including age, gender, stage (Masaoka), histologic subtypes (squamous cell/others), type of resection (complete/incomplete), tumor size, induction and adjuvant therapy (chemotherapy-ChT/radiotherapy-RT), recurrence. Primary outcome was overall survival (OS); secondary outcomes were disease-free survival (DFS) and the cumulative incidence of recurrence. Survival analysis was performed using univariate and multivariate (Cox-shared frailty) competing-risk models. Missing data were analysed using multiple-imputation techniques Results: A multidisciplinary approach (surgery, ChT and RT) was used in most patients. Induction therapy was employed in 78 patients (ChT, 53; ChT/RT 23; RT, 2). Adjuvant therapy was employed in 150 patients (ChT, 19; ChT/RT, 72; RT, 59). Complete resection (R0) was achieved in 71% of the patients. Five and 10-year OS were 60% and 35%. Five and 10-year DFS were 62% and 43%. Cumulative incidence of recurrence was 0.25, 0.32 and 0.40 at 3, 5, and 10 years. Independent OS predictors (multivariate analysis) were young age (p=0.006), stage I/II (vs. III/IV, p=0.02), R0 resection (p<0.001), adjuvant therapy (ChT, RT or both) (p=0.02). Independent predictor of recurrence (univariate analysis) was tumor size (p=0.05). Conclusions: In thymic carcinomas submitted to surgical resection, increased age,Masaoka stages III-IV and incomplete resection had a significant impact in worsening survival. Larger tumors had an increased risk of recurrence. The administration of adjuvant ChT or RT was associated with improved overall survival. A multidisciplinary approach to these rare tumors remains essential.

Datum přednesení příspěvku: 31. 5. 2013