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• W3136183172 abstract "TET are rare malignancies, with an annual incidence of 350 cases in France. The main prognostic factors are Masaoka-koga stage and quality of the resection. However, no large cohorts have been published concerning resection outcomes. RYTHMIC (Réseau tumeurs THYMiques et Cancer) is a French network mandated to systematically discuss every case of TET. We aimed to describe the resected tumor outcomes in a large French population. RYTHMIC database, hosted by IFCT (Intergroupe Francophone de Cancérologie Thoracique), prospectively includes all consecutive pts with a diagnosis of TET discussed in French national or regional tumor boards. We analyzed epidemiologic, clinical and pathological characteristics of 1045 pts operated of a TET. From January 2012 to December 2019, 2909 pts were included in the database. Overall, the median age at diagnosis of TET was 60 (range 9-90) and 52% (n=1513) were male. Of them, 1082 (37,2%) pts were operated. 304/1045 (29%) pts reported autoimmune disorders and Myasthenia Gravis was the most common (250 pts, 82,2%). Masaoka-Koga stages (MK) were well balanced with 23% (n=240) stage I, 17.2% (n=180) stage IIa, 18.2% (n=190) stage IIb, 19.6% (n=205) stage III with lung as a main invaded organ (37%), 8% (n=85) stage IVa and 4.9% (n=51) stage IVb. Among resected tumors, B2 and AB were the most common subtypes (n=247, 23.6% and n=237, 22.7% respectively). Sternotomy was the most used approach for resection (n=735, 70.3%). In addition to TET, surgery was extended to lung (35%), pericardium (24%), pleura (13%), recurrent nerve or great vessels (10%) and lymph nodes (46%). Complete resection was assessed in 71% of procedures with a median tumor size of 55mm (1-260) and a range of 0-28 resected pleural metastasis. Intrapleural chemotherapy was used as an associated technique during the first-line surgery (6/17 pts) or after recurrence (9/17 pts, 53%) shrinking the hazard for progression (PD) (OR= 0.5 95%CI [0.29 to 0.84], p<0.00). Induction chemotherapy and adjuvant radiotherapy was administered in 119/182 (65,3%) and 357/1045 (34.2%) pts, respectively. Principal location for progression was the pleura (119/223 pts, 53%) with surgery as the main treatment (31%). Median-OS was 263 months (95%CI[NotR-NotR]) and median-PFS was 111 months (95%CI[97,4-124,5]). The Cox proportional Hazard’s model showed a statistically significant greater risk for PD of MK III comparing with other localized tumors (HR=10,618 95%CI[1,172-96,224], p=0,036). Patients presenting thymoma B3 and epidermoid thymic carcinoma assessed risk for PD (HR=1,357 95%[0,531-3,462]; p=0,524 and HR= 1,982 95%CI[0,774-5,073]; p=0,154, respectively). Patients who needed lung or phrenic nerve resection showed higher risk for PD (HR=1,643 95%CI[1,181-2,286]; p=0,003 and HR=1,829 95%CI[1,217-2,748]; p=0,003, respectively). Bigger tumors and those with no complete resection (R1) were more likely to progress (HR=1,009 95%CI[1,004-1,013]; p<0,00 and HR=1,821 95%CI[1,058-3,133]; p=0,03, respectively). Up to 37% of RYTHMIC cohort were resected. MK I and III were the most common resected tumors with 71% of complete resection with impact on survival. Thymic carcinoma and thymoma B3 were more likely to progress. Pleura was the main site for recurrence and surgery the most used treatment, in addition with intrapleural chemotherapy in some cases." @default.
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• W3136183172 date "2021-03-01" @default.
• W3136183172 modified "2023-09-27" @default.
• W3136183172 title "FP05.04 Outcomes of Resected Thymic Epithelial Tumors (TET), insights from RYTHMIC" @default.
• W3136183172 doi "https://doi.org/10.1016/j.jtho.2021.01.096" @default.
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