Retrospective Review Of All Patients With Thymoma Treated Over The Last 33 Years At The Royal Marsden Hospital

7095 Background: Thymomas are rare epithelial tumours of the thymus. A variety of strategies can be used for locally advanced/recurrent disease as well as differing systemic therapies for advanced stage. Few trials have been performed on these patients. Methods: We retrospectively reviewed case notes of all patients with thymoma at our institution (1976-2009). Demographic, pathological, and clinical details were recorded, including surgical intent and survival. Tumors were classified by WHO status and Masaoka stage. Survival was calculated from the date of presentation at the Marsden using the Kaplan-Meier method. Results: 104 patients were identified (59M, 45F; age 16-83, median 47 years). Most patients (n=63, 60%) had stage 3/4 disease (21 /42, respectively). 57 patients (55%) were classifiable to WHO subtype with 2/12/18/18/28/23% subtypes A/AB/B1/B2/B3/C, respectively. 45% were diagnosed prior to WHO classification. All stage 1 patients had surgery (n=3). In stage 2, 93% (n=14) had surgery, followed by radiotherapy in 53%. Stage 3 (n=21) management varied widely. Stage 4a (n=24) was treated with debulking surgery followed by chemo/radiotherapy. 4b were treated by chemotherapy. First-line chemotherapy regimes varied widely. Platinum based treatments accounted for 56 % of all regimes given, the commonest being CAP (19%). Platinum combinations also formed the mainstay of second-line chemotherapy (59%). Median overall survival was 5.4 years, and depended on stage: median for stage 1&2/3/4 was not reached/4.5/4.3 years, respectively (p=0.001). Whilst survival for males was marginally better (p=0.07), age at diagnosis was not prognostic: (p=0.2). Notably, survival was similar in patients diagnosed before and after 1995 (5.8 vs. 5.4 years, p=0. Conclusions: This heterogeneous dataset reflects the referral pattern to our center and tumor rarity. The lack of survival gain over the past 30 years strengthen the call for an international interest group and tumor registry to drive collaborative trials and translational research. No significant financial relationships to disclose.