WCLC 2025 - Posters & ePosters-EP.14.15 Patterns of Failure and Long-Term Outcomes in Patients With Thymoma Treated With Surgery and Radiation Therapy

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This retrospective cohort study analyzed 175 patients with thymic malignancies treated with curative-intent surgery followed by postoperative radiation therapy (PORT) at a single center from 2004 to 2024. The study aimed to characterize patterns of failure and identify clinicopathologic predictors of recurrence. Data included clinical characteristics, histopathology, treatment details, and imaging to confirm recurrence, which was assessed radiographically.<br /><br />Key findings showed that long-term survival outcomes were generally favorable. Out of all recurrences observed, 76% occurred in the pleura, while mediastinal lymph nodes, lung parenchyma, and distant metastases were less common sites (6.5%, 5%, and 5%, respectively). Only 5% of recurrences occurred within the radiation field, indicating effective local control by PORT.<br /><br />Univariate analysis identified several factors significantly associated with increased recurrence risk, including positive resection margins, fat invasion, pericardial invasion, pleural invasion, lung parenchyma invasion, vessel invasion, larger tumor size, and higher Masaoka stage (stage 3-4 versus 1-2). Multivariable analysis highlighted vessel invasion (odds ratio 3.41) and younger patient age as independent predictors of recurrence, while higher Masaoka stage correlated with a lower recurrence risk, possibly reflecting treatment selection biases.<br /><br />The study concludes that thymic malignancies treated with surgery and PORT yield excellent long-term outcomes, with most recurrences occurring outside the radiation field, affirming current treatment effectiveness. Furthermore, recurrence relates more to local invasive features than histologic subtype. The authors emphasize the need for further research to optimize management for patients with high-risk invasive disease to improve outcomes.<br /><br />Overall, this study advances understanding of failure patterns and prognostic factors in thymoma patients undergoing surgery and radiation, guiding tailored post-treatment surveillance and potential therapeutic strategies.

Asset Subtitle

Oded Icht

Meta Tag

Speaker Oded Icht

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

thymic malignancies

curative-intent surgery

postoperative radiation therapy

patterns of failure

recurrence predictors

pleural recurrence

vessel invasion

Masaoka stage

long-term survival

treatment outcomes