Rea Federico, Marulli Giuseppe, Girardi Rodolfo, Bortolotti Luigi, Favaretto Adolfo, Galligioni Alessandra, Sartori Francesco
Thoracic Surgery, University of Padua, via Giustiniani, 2, 35128 Padua, Italy.
Eur J Cardiothorac Surg. 2004 Aug;26(2):412-8. doi: 10.1016/j.ejcts.2004.04.041.
The aim of this study is to analyze long-term survival and the prognostic significance of some factors after surgical resection of thymic epithelial tumours.
We performed a retrospective analysis of clinical and histopathological data on 132 patients operated on for thymic tumours, from 1970 and 2001. Histologic diagnosis based on the new WHO classification system was made by a single pathologist. A univariate and multivariate analysis of prognostic factors predicting survival was carried out.
There were: 108 complete resections (81.8%), 12 partial resections (9.1%) and 12 biopsies (9.1%). Overall 5, 10 and 15-year survival rate was 72, 61 and 52.5%, respectively. The Masaoka staging system showed 44 stage I, 18 stage II, 52 stage III and 18 stage IV. Histologic results were: 14 subtype A, 31 AB, 20 B1, 28 B2, 29 B3 and 10 C; the respective proportions of invasive tumour (stage II-IV) was 28.6, 58.1, 50, 75, 86.2 and 100%. There were 16 tumour recurrences (14.8%) of 108 radically resected thymomas, 10 were treated with radical re-resection. In univariate analysis, four prognostic factors were statistically significant: radical resection, Masaoka clinical staging, WHO histologic subtype and resectable tumour recurrence. In multivariate analysis, the independent factors predicting long-term survival were WHO histology and Masaoka stage.
The WHO histologic classification seems to be the most significant prognostic factor reflecting the invasiveness of the thymic tumour. Completeness of resection and Masaoka stage I and II assure a better survival. Unresectable recurrence of thymic tumour predicted a worse prognosis.
本研究旨在分析胸腺上皮肿瘤手术切除后的长期生存率以及某些因素的预后意义。
我们对1970年至2001年间接受胸腺肿瘤手术的132例患者的临床和组织病理学数据进行了回顾性分析。基于世界卫生组织新分类系统的组织学诊断由一名病理学家做出。对预测生存的预后因素进行了单因素和多因素分析。
有108例完整切除（81.8%），12例部分切除（9.1%）和12例活检（9.1%）。总体5年、10年和15年生存率分别为72%、61%和52.5%。Masaoka分期系统显示44例I期，18例II期，52例III期和18例IV期。组织学结果为：14例A型，31例AB型，20例B1型，28例B2型，29例B3型和10例C型；侵袭性肿瘤（II - IV期）的相应比例分别为28.6%、58.1%、50%、75%、86.2%和100%。108例根治性切除的胸腺瘤中有16例肿瘤复发（14.8%），其中10例接受了根治性再次切除。单因素分析中，四个预后因素具有统计学意义：根治性切除、Masaoka临床分期、世界卫生组织组织学亚型和可切除的肿瘤复发。多因素分析中，预测长期生存的独立因素是世界卫生组织组织学类型和Masaoka分期。
世界卫生组织组织学分类似乎是反映胸腺肿瘤侵袭性的最重要预后因素。切除的完整性以及Masaoka I期和II期可确保更好的生存率。胸腺肿瘤不可切除的复发预示着更差的预后。
Zotero 插件