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215例胸腺上皮性肿瘤的手术结果:单中心经验

已有 164 次阅读2021-3-31 17:14 |个人分类:TET学习|系统分类:医学科学

215例胸腺上皮性肿瘤的手术结果:单中心经验
Surgical outcomes of 215 patients with thymic epithelial tumors: A single-center experience
目的:评价胸腺切除术后胸腺上皮性肿瘤(TETs)的肿瘤预后及神经预后。
方法:回顾性分析北京医院2011年1月至2018年12月连续行胸腺切除术的TETs患者。收集临床、病理及围手术期资料。随访患者的电话访谈和门诊记录。采用SPSS 19.0版进行统计分析。
结果:本研究共215例(男115例,女100例),其中重症肌无力合并TETs 133例(61.9%),无MG胸腺肿瘤82例(38.1%)。随访成功194例(90.2%)。随访期中位数为42个月。5年总生存率为88.6%。MG是MG患者的第一死因(6/10)。MG患者的预后与无MG患者相似。多元Cox回归分析表明TNMⅢ+IV期是手术的独立危险因素不完全切除和年龄小是肿瘤复发的危险因素。MG患者术后随访期累计完全稳定缓解率(CSR)升高,5年CSR率为44.7%。单因素Cox分析表明,年龄、术前MG持续时间和术前用药可能与CSR相关。多元Cox分析仅表明老年人是实现社会责任的一个负因素。
结论:MG对胸腺肿瘤的OS和肿瘤复发影响不大。新的TNM分期系统是一个独立的预后因素。不完全切除和年龄小是肿瘤复发的危险因素。老年人是胸腺切除术后MG胸腺瘤患者实现CSR的负因素。
要点:研究的重要发现MG不是胸腺肿瘤的预后因素。新的TNM分期系统对预测预后有一定的参考价值。不完全切除和年龄小是肿瘤复发的危险因素。年龄越大,胸腺MG的CSR发生率越低。本研究补充说,这项研究在一个中心有一个相对较大样本量的胸腺上皮肿瘤患者。我们不仅评估了胸腺切除术后的肿瘤预后,而且还评估了神经系统的预后,这是一种更全面的胸腺上皮性肿瘤手术效果评估。
关键词:预后;胸腺切除术;胸腺上皮瘤。
Objectives: To evaluate the oncological prognosis and neurological outcomes for patients with thymic epithelial tumors (TETs) after thymectomy.
Methods: Consecutive patients with TETs who underwent thymectomy at Beijing Hospital from January 2011 to December 2018 were retrospectively enrolled into the study. Clinical, pathological, and perioperative data was collected. Patients were followed-up by telephone interview and outpatient records. Statistical analyses were performed using SPSS version 19.0.
Results: A total of 215 patients (115 men and 100 women) were included in this study of which 133 patients (61.9%) had TETs associated with myasthenia gravis (MG), and 82 patients (38.1%) had thymic tumors without MG. A total of 194 (90.2%) patients were successfully followed-up. The median follow-up period was 42 months. The five-year overall survival (OS) rate was 88.6%. MG was the first cause of death for patients with MG (6/10). Prognosis in MG patients was similar to those without MG. Multivariate Cox regression analysis demonstrated that TNM stage III + IV was an independent risk factor for OS. Incomplete resection and younger age were risk factors for tumor recurrence. For patients with MG, the cumulative complete stable remission (CSR) rate increased with the postoperative follow-up period, and the five-year CSR rate was 44.7%. Univariate Cox analysis indicated that age, preoperative MG duration and preoperative medication might correlate with CSR. Multivariate Cox analysis only indicated older age as a negative factor of achieving CSR.
Conclusions: MG had little influence on OS and tumor recurrence of thymic tumors. The new TNM staging system was an independent prognostic factor. Incomplete resection and younger age were risk factors for tumor recurrence. Older age was a negative factor of achieving CSR for thymoma patients with MG after extended thymectomy.
Key points: Significant findings of the study MG was not a prognostic factor for thymic tumors. The new TNM staging system was useful for prediction of prognosis. Incomplete resection and younger age were risk factors for tumor recurrence. Older age led to a lower probability of achieving CSR for thymomatous MG. What this study adds This study had a relatively large sample size of patients with thymic epithelial tumors in a single center. We evaluated not only the oncological prognosis, but also neurological outcomes after thymectomy, which was a more comprehensive assessment of surgical effect for thymic epithelial tumors.
Keywords: Prognosis; thymectomy; thymic epithelial tumor.
Tian W, Sun Y, Wu Q, Jiao P, Ma C, Yu H, Huang C, Tong H. Surgical outcomes of 215 patients with thymic epithelial tumors: A single-center experience. Thorac Cancer. 2020 Jul;11(7):1840-1847.

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回复 hyc3140 2021-4-2 14:35
To our knowledge, this is also the first large MRI study to assess optic chiasm compression in somatotropinomas

As far as we know,

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