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Clinical features, management and outcomes of patients with thymoma and thymic carcinoma in a multicentre UK series

Project Lead: Dr Abigail Gault

Project Status: Closed

BTOG 2020 Poster Presentation Winner

Accepted for Poster Presentation at ESTRO 2023

Manuscript writing underway 

Introduction: Thymic carcinoma and thymoma are rare, accounting for less than 1% of adult cancers and associated with poor prognosis. Surgical resection forms the mainstay of treatment. Adjuvant radiotherapy is recommended for stage II-III disease and adjuvant chemotherapy recommended in stage IV disease. Although there are data series from other countries, and single site data from the UK the types of treatments offered within the NHS and patient outcomes have not been evaluated in the era of personalised medicine.

Methods: Three hundred and thirty two consecutive adult patients presenting with histologically or radiologically diagnosed thymoma, thymic carcinoma or thymic carcinoid between November 2008 and November 2018 at six centres were retrospectively identified. Leeds Cancer Centre, the Northern Centre for Cancer Care, Clatterbridge Cancer Centre, The Christie Hospital, Northern Ireland Cancer Centre and Sheffield Cancer Centre participated. Study concept, design and delivery were overseen by NOTCH.

Results: Our cohort included 167 male patients and 163 female. Average age at diagnosis was 60 years (range 25–88 years). Of this population, 250 had thymoma and 74 had thymic carcinoma. The most common presenting symptom was dyspnoea (27%), however 24% were asymptomatic. Forty-nine patients were Masoaka stage 4 at diagnosis, 52 were stage 3, 124 stage 2 and 75 were stage 1. Most patients received surgery upfront (249), 60 received chemotherapy, and 8 received radiotherapy. For stage IV patients, the most common chemotherapy regimen first line was platinum and etoposide.

Conclusion: This project has highlighted the scope of NHS practice within the UK. Current UK practice correlates with ESMO guidance [9] in terms of systemic therapies, although less patients received adjuvant therapy (120 patients) compared to those eligible (176 stage II and III patients).

Disclosure: All authors have declared no conflicts of interest.

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