Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo, Tokyo 113-8677, Japan.
Lung Cancer. 2013 Apr;80(1):75-80. doi: 10.1016/j.lungcan.2012.12.012. Epub 2013 Jan 11.
The clinical characteristics and prognostic factors of thymic carcinoma have not been investigated in detail because of its rarity. The aim of this study was to elucidate the disease profile, outcomes, and prognostic factors for survival among patients with advanced thymic carcinoma treated with palliative-intent chemotherapy.
A retrospective review was conducted of the medical records of 40 patients treated with palliative-intent chemotherapy for advanced thymic carcinoma between 1991 and 2011 in our institution. Clinical demographics, histology, overall survival, and factors expected to predict survival were analyzed. Differences in survival were assessed using Kaplan-Meier analysis and univariate and multivariate Cox proportional hazards regression analyses.
The study included 22 males (55.0%) and 18 females (45.0%). The median age at diagnosis was 58.5 years. The most common metastatic sites at diagnosis were lung (45.0%), lymph nodes (20.0%), liver (15.0%), bone (15.0%), and brain (5.0%). The most common histological subtypes were squamous cell carcinoma (70.0%), followed by neuroendocrine carcinoma (17.5%), and mucoepidermoid carcinoma (7.5%). The response rate for first-line chemotherapy was 47.5%. The median survival time was 24.5 months (95% confidence interval 20.9-43.5 months). Overall survival rates at 1-, 2-, and 5-years were 72.5%, 52.5%, and 17.5%, respectively. In uni- and multivariate analyses, the only favorable prognostic factor for overall survival was response to first-line chemotherapy (p=0.01).
Response to first-line chemotherapy may be implicated as a potential surrogate for survival in advanced thymic carcinoma.
由于胸腺癌罕见，其临床特征和预后因素尚未得到详细研究。本研究旨在阐明接受姑息性化疗的晚期胸腺癌患者的疾病特征、结局和生存预后因素。
对 1991 年至 2011 年间我院收治的 40 例接受姑息性化疗的晚期胸腺癌患者的病历进行回顾性分析。分析了临床人口统计学、组织学、总生存期以及预期可预测生存的因素。采用 Kaplan-Meier 分析和单因素及多因素 Cox 比例风险回归分析评估生存差异。
本研究包括 22 例男性（55.0%）和 18 例女性（45.0%）。诊断时的中位年龄为 58.5 岁。诊断时最常见的转移部位是肺（45.0%）、淋巴结（20.0%）、肝（15.0%）、骨（15.0%）和脑（5.0%）。最常见的组织学亚型是鳞状细胞癌（70.0%），其次是神经内分泌癌（17.5%）和黏液表皮样癌（7.5%）。一线化疗的缓解率为 47.5%。中位生存时间为 24.5 个月（95%置信区间 20.9-43.5 个月）。1 年、2 年和 5 年总生存率分别为 72.5%、52.5%和 17.5%。单因素和多因素分析均表明，总生存的唯一有利预后因素是一线化疗的缓解（p=0.01）。
一线化疗的缓解可能暗示着晚期胸腺癌患者的生存预后。
