2024 World Conference on Lung Cancer (WCLC) - Posters-P2.14A.03 Prediction of Post-Surgical Recurrence of Thymic Epithelial Tumours Using Clinicopathological Parameters Incorporating TNM9 Classification

P2.14A.03 Prediction of Post-Surgical Recurrence of Thymic Epithelial Tumours Using Clinicopathological Parameters Incorporating TNM9 Classification

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The study presents a predictive model for recurrence risk in patients with thymic epithelial tumors (TET), utilizing clinicopathological variables and the ninth edition of the TNM classification (TNM9). The research aims to integrate various parameters into a coherent prognostic system to address inconsistent findings from earlier studies regarding TET recurrence predictions.<br /><br />Conducted at a single institution, the retrospective study analyzed 436 cases of TET registered between 1991 and 2022, excluding cases lacking subtype information according to the WHO 2021 Classification or those with complete pathological response post-neoadjuvant therapy. Historical data was incorporated for comprehensive analysis, covering procedures performed from 1980 to 2000.<br /><br />The study employed the Kaplan-Meier method to evaluate recurrence-free survival (RFS) linked to clinicopathological variables, advancing to multivariate Cox regression to ascertain independent recurrence predictors with statistical significance.<br /><br />Key findings indicate that histological risk groups, presence of tumor necrosis, TNM9 staging, and resection status emerged as independent predictors of recurrence. Specifically, high-risk histological subtypes such as thymic neuroendocrine carcinoma were shown to correlate with increased recurrence risk, overshadowing other variables.<br /><br />A point-based model stratifies recurrence risk into four tiers: very low, low, intermediate, and high. This model achieved an area under the curve (AUC) of 0.859, indicating robust predictive capability. The high recurrence risk was associated with a significant decrease in RFS, emphasizing the utility of this integrated model in stratifying patient management and guiding follow-up care.<br /><br />The study underscores the necessity for independent validation of these findings, proposing the model as a tool for postoperative management, risk-based stratification, and the potential de-escalation of therapeutic interventions in TET patients with very low recurrence risk. This research supports the refinement of the TNM9 classification, emphasizing a more nuanced and integrated approach to patient care.

Asset Subtitle

Yu Zhi Zhang

Meta Tag

Speaker Yu Zhi Zhang

Topic Mesothelioma, Thymoma & Other Thoracic Tumors

Keywords

thymic epithelial tumors

recurrence risk

predictive model

TNM classification

clinicopathological variables

Kaplan-Meier method

Cox regression

histological subtypes

recurrence-free survival

postoperative management