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胸腺瘤和胸腺癌:预后因素与多模式管理

Thymomas and thymic carcinomas: prognostic factors and multimodal management.

作者信息

Moser Bernhard, Scharitzer Margit, Hacker Stefan, Ankersmit Jan, Matilla Jose Ramon, Lang Georg, Aigner Clemens, Taghavi Shahrokh, Klepetko Walter

机构信息

Medical University of Vienna-Thoracic Surgery Wien, Wien, Austria.

Medical University of Vienna-Plastic Surgery Wien, Wien, Austria.

出版信息

Thorac Cardiovasc Surg. 2014 Mar;62(2):153-60. doi: 10.1055/s-0032-1322611. Epub 2012 Dec 6.

Abstract

BACKGROUND

Thymomas and thymic carcinomas are rare malignant tumors. We report the experience with the resection and multimodal treatment at a single department in Central Europe in the years 2001 to 2010.

OBJECTIVE

We sought to determine prognostic factors in this patient population.

METHODS

A 10-year retrospective analysis of 84 resections on 72 patients for thymomas/thymic carcinomas or their recurrences was performed.

RESULTS

Patients admitted to a single thoracic surgery center presented with Masaoka-Koga stage I (29.2%), II (43.1%), III (13.9%), and IV (13.9%). In approximately 88.9% of cases, a complete resection could be reached. Using overall survival as an outcome measure, the 5-year survival rate was 87%. Of all the cases presented, 9.7% cases showed tumor recurrence and 6.9% cases showed tumor progression. There was decreased survival rate with increasing Masaoka-Koga stage (p = 0.017) and incomplete resection (p < 0.001).

CONCLUSION

Completeness of resection and Masaoka-Koga stage were significant prognostic factors. Multidisciplinary treatments of patients with thymoma or thymic carcinoma result in good patient care, and global efforts with larger number of patients are needed to elucidate more about the biology, diagnosis, and treatment of these tumors.

摘要

背景

胸腺瘤和胸腺癌是罕见的恶性肿瘤。我们报告了2001年至2010年在中欧某单一科室进行手术切除及多模式治疗的经验。

目的

我们试图确定该患者群体的预后因素。

方法

对72例患者的84次胸腺瘤/胸腺癌切除或复发手术进行了为期10年的回顾性分析。

结果

入住单一胸外科中心的患者Masaoka-Koga分期为I期(29.2%)、II期(43.1%)、III期(13.9%)和IV期(13.9%)。在大约88.9%的病例中,能够实现完全切除。以总生存期作为观察指标,5年生存率为87%。在所有病例中,9.7%的病例出现肿瘤复发,6.9%的病例出现肿瘤进展。随着Masaoka-Koga分期增加(p = 0.017)和切除不完全(p < 0.001),生存率降低。

结论

切除的完整性和Masaoka-Koga分期是重要的预后因素。胸腺瘤或胸腺癌患者的多学科治疗可实现良好的患者护理,需要全球范围内纳入更多患者的努力,以更深入地阐明这些肿瘤的生物学特性、诊断和治疗方法。

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