2023 World Conference on Lung Cancer (Posters)-P2.20. The Impact of Preoperative Immunotherapy On Peri-Operative Outcomes After Thymectomy for Thymic Epithelial Tumors

P2.20. The Impact of Preoperative Immunotherapy On Peri-Operative Outcomes After Thymectomy for Thymic Epithelial Tumors - PDF(Abstract)

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A study evaluated the use of preoperative immunotherapy (IO) in patients with thymic epithelial tumors (TET) undergoing thymectomy and its impact on perioperative and oncologic outcomes. The study analyzed data from the National Cancer Database from 2004-2020 and compared patients who received preoperative IO with or without chemoradiotherapy, chemotherapy alone, or chemoradiotherapy followed by thymectomy. The primary endpoint was major perioperative morbidity, defined as a composite of peri-operative mortality, hospital length of stay (LOS), and readmission.<br /><br />Of the 1,976 patients included in the study, only 54 patients (2.7%) received preoperative IO. The IO group had a higher proportion of thymoma, smaller tumor size, open surgery, and treatment at an academic or research program. The use of IO was associated with a shorter time from diagnosis to surgery. The 30-day mortality rates were low overall but lowest in the IO group. There were no significant differences in LOS or readmission rates between the groups. However, the rate of positive margins was highest in the chemoradiation group, followed by the IO group, and then the chemotherapy group.<br /><br />Non-white race and thymoma were independent predictors of a complicated perioperative course, while treatment at an academic or research program and receiving neoadjuvant chemotherapy were associated with higher rates of R0 resection. Propensity matched analysis showed no significant differences from the primary analysis.<br /><br />The study concluded that the use of preoperative IO for TET is associated with favorable tolerability and is not associated with worse perioperative morbidity. However, it does lead to higher rates of positive margins compared to standard chemotherapy alone treatment. The results support ongoing investigations aimed at expanding options for neoadjuvant treatment in TET.

Asset Subtitle

Lye-Yeng Wong

Meta Tag

Speaker Lye-Yeng Wong

Topic Thymic Malignancy

Keywords

preoperative immunotherapy

thymic epithelial tumors

thymectomy

perioperative outcomes

chemoradiotherapy

chemotherapy

major perioperative morbidity

positive margins

neoadjuvant chemotherapy

R0 resection