AB053. The role of local therapy in oligo-recurrent metastatic thymic epithelial tumors: a monocentric retrospective analysis
Original Research

AB053. The role of local therapy in oligo-recurrent metastatic thymic epithelial tumors: a monocentric retrospective analysis

Nadia Cordua1,2, Emanuele Voulaz3, Davide Franceschini4, Matteo Perrino2, Marta Aliprandi1, Luigi Cecchi1, Alessandro Bertocchi1, Antonio Federico1, Fabio De Vincenzo2, Giuseppe Marulli1,3, Marta Scorsetti1,4, Paolo Andrea Zucali1,2

1Department of Biomedical Sciences, Humanitas University, Milan, Italy; 2Department of Oncology, IRCCS Humanitas Research Hospital, Milan, Italy; 3Department of Thoracic Surgery, IRCCS Humanitas Research Hospital, Milan, Italy; 4Department of Radiotherapy, IRCCS Humanitas Research Hospital, Milan, Italy

Correspondence to: Nadia Cordua, MD. Department of Oncology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milano, 20090, Italy. Email: nadia.cordua@humanitas.it.

Background: Thymic epithelial tumors (TETs) are rare cancers, and limited data are available in the literature regarding the management of metastatic disease. In particular, for patients with metastatic oligo-recurrent disease, the use of local treatments instead of systemic therapy is sometimes considered by clinicians, although the supporting evidence is weak. We aim to retrospectively evaluate a series of patients with metastatic oligo-recurrent TETs treated with local therapy.

Methods: A monocentric retrospective trial was conducted selecting patients with TETs who were treated with local therapy (surgery or radiotherapy) for metastatic oligo-recurrent disease following radical surgery of the primary tumor. Data were collected on clinical characteristics, date and localization of recurrences, type of local treatments, date of disease progression after local therapy, and follow-up. The data were analyzed using Statistical Analysis System (SAS) version 9.4.

Results: A total of 38 patients with TETs (30 thymomas; 8 thymic carcinomas) were included. Disease recurrence was detected in a single site in 18 patients (47.4%), in two sites in 14 patients (36.8%), and in three or more sites in 6 patients (15.8%). The most frequent sites of recurrence were pleura alone in 14 patients (36.8%), chest wall in 14 patients (36.8%), and lung in 10 (26.3%). Oligo-recurrent disease was confined to a single organ in 25 patients (65.8%) and to multiple organs in 13 patients (34.2%). Local therapy for oligo recurrence consisted of surgery alone in 15 patients (39.5%), radiotherapy alone in 7 (18.4%), radiotherapy plus surgery in 6 (15.8%), surgery plus chemotherapy in 6 (15.7%), radiotherapy plus chemotherapy in 2 (5.3%), and surgery combined with both radiotherapy and chemotherapy in 2 (5.3%). Following local therapy, 26 patients (68.4%) experienced progression of disease. Among them, 16 patients (61.5%) received an additional local therapy, while 10 (38.5%) received systemic treatment. The median progression-free survival (PFS) was 26.5 months [95% confidence interval (CI): 16–41]. The 6- and 12-month PFS rates were 85.9% and 79.7%, respectively. The median overall survival (OS) was 100.3 months (95% CI: 84–not reached) with the 1- and 5-year OS rates of 100% and 89%, respectively.

Conclusions: Local treatment of metastatic oligo-recurrent TETs seems to be associated with prolonged survival. An enlargement of the case study and a prospective evaluation could provide stronger evidence to support this therapeutic approach.

Keywords: Oligo-recurrent; metastatic disease; local therapy

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-25-ab053/coif). M.P. serves as a board director for Bayer, Astellas, Johnson&Johnson, BMS, and received payment for his board role and support for attending meetings/or travel. P.A.Z. serves as a board director for Merck Sharp & Dohme, Astellas, Janssen, Sanofi, Ipsen, Pfizer, Novartis, Bristol Meyer Squibb, Amgen, AstraZeneca, Roche, and Bayer, and received payment and support from them. The other authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the regional ethics board (Comitato etico territoriale Lombardia 5) (No. 4370) and individual consent for this retrospective analysis was waived.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/med-25-ab053
Cite this abstract as: Cordua N, Voulaz E, Franceschini D, Perrino M, Aliprandi M, Cecchi L, Bertocchi A, Federico A, De Vincenzo F, Marulli G, Scorsetti M, Zucali PA. AB053. The role of local therapy in oligo-recurrent metastatic thymic epithelial tumors: a monocentric retrospective analysis. Mediastinum 2025;9:AB053.

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