Masaoka 分期和组织学分级可预测胸腺癌患者的预后。

Masaoka stage and histologic grade predict prognosis in patients with thymic carcinoma.

机构信息

Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

出版信息

Ann Thorac Surg. 2010 Mar;89(3):912-7. doi: 10.1016/j.athoracsur.2009.11.057.

DOI:10.1016/j.athoracsur.2009.11.057

PMID:20172153

Abstract

BACKGROUND

Thymic carcinoma is a rare tumor. Limited data are available regarding the effectiveness of treatment and the prognosis of thymic carcinoma. The present study aimed to clarify the prognostic factors in patients who underwent resection.

METHODS

The study retrospectively reviewed 21 patients (15 men, 6 women) with thymic carcinoma who had undergone resection at Niigata University Hospital.

RESULTS

Masaoka stage was II in 4 patients, III in 9, IVa in 2, and IVb in 6. Histologic subtypes were squamous cell carcinoma in 14 patients, adenocarcinoma in 2, atypical carcinoid in 3, and undifferentiated carcinoma in 2. Histologic grade by degree of differentiation was low in 4 tumors, intermediate in 12, and high in 5. Treatment comprised resection alone in 6 patients and resection along with multimodal therapies in 15. Complete resection was achieved in 14 (67%). Eight patients died of tumor. Recurrence was documented in 7 of 14 patients with complete resection, and 5 received additional treatment. The overall 5-year survival rate was 61.1%, and the disease-free 5-year survival rate was 66.8% for the 14 with complete resection. By multivariate analysis, Masaoka stage and histologic grade were significant independent prognostic factors for overall survival.

CONCLUSIONS

The surgical outcome of patients with thymic carcinoma depends on the Masaoka stage and histologic grade. Patients with early Masaoka stage and low or intermediate histologic grade had favorable prognoses.

摘要

背景

胸腺癌是一种罕见的肿瘤。关于胸腺癌的治疗效果和预后，相关数据有限。本研究旨在明确接受切除术患者的预后因素。

方法

本研究回顾性分析了在新泻大学医院接受切除术的 21 例胸腺癌患者（15 名男性，6 名女性）的临床资料。

结果

Masaoka 分期为Ⅱ期的患者有 4 例，Ⅲ期的有 9 例，Ⅳa 期的有 2 例，Ⅳb 期的有 6 例。组织学亚型包括 14 例鳞状细胞癌、2 例腺癌、3 例非典型类癌和 2 例未分化癌。按分化程度分级，低分化肿瘤 4 例，中分化肿瘤 12 例，高分化肿瘤 5 例。6 例患者仅接受手术治疗，15 例患者接受手术联合多模式治疗。14 例患者达到完全切除，其中 8 例患者因肿瘤死亡。7 例完全切除患者复发，5 例患者接受了额外的治疗。总的 5 年生存率为 61.1%，完全切除的 14 例患者的无病 5 年生存率为 66.8%。多因素分析显示，Masaoka 分期和组织学分级是总生存率的独立预后因素。