Department of Clinical Oncology, Cervesi Hospital, Cattolica, RN, Italy.
Ann Surg Oncol. 2013 Sep;20(9):2958-63. doi: 10.1245/s10434-013-3018-2. Epub 2013 May 26.
This multicenter analysis evaluated patient outcome and clinical pathologic features of thymic epithelial tumors after complete surgical resection and adjuvant treatment.
Histologic classification and clinical staging were performed according to WHO classification and Masaoka staging system, respectively.
We analyzed 62 patients, 20 (32%) of whom had myasthenia at diagnosis. Clinical and pathologic staging was as follows: 31 (50%) and 30 (48%) patients had stage I disease, 19 (30%) and 22 (35%) stage II, 5 (8%) and 3 (6%) stage III, 2 (4%) and 2 (3%) stage IVa, and 5 (8%) and 5 (8%) stage IVb, respectively. Histologic examination revealed 11 (19%) type A tumors, 19 (30%) type AB tumors, 7 (12%) type B1 tumors, 11 (17%) type B2 tumors, 11 (17%) type B3 tumors, and 3 (5%) type C tumors. Adjuvant therapies comprised chemotherapy in 3 (5%) patients and radiotherapy in 16 (26%) patients. Median follow-up was 71 months (range 1-145). DFS and OS at 48, 60, and 72 months were 89 and 89%, 86 and 97%, and 95% and 92%, respectively. Myasthenia at the onset of disease (P=0.18 for DFS; P=0.97) and tumor size>5 cm (P=0.94 for DFS; P=0.56) were not prognostic factors.
TETs are rare and indolent tumors. Complete surgical resection followed by adjuvant therapies, such as chemotherapy and/or radiotherapy, in patients at risk of recurrence show very good DFS and OS results, even in cases with radically resected pleural-pulmonary metastases.
本多中心分析评估了完全手术切除和辅助治疗后胸腺瘤患者的预后和临床病理特征。
根据世界卫生组织分类和 Masaoka 分期系统进行组织学分类和临床分期。
我们分析了 62 例患者，其中 20 例（32%）在诊断时存在重症肌无力。临床和病理分期如下：31 例（50%）和 30 例（48%）为 I 期疾病，19 例（30%）和 22 例（35%）为 II 期，5 例（8%）和 3 例（6%）为 III 期，2 例（4%）和 2 例（3%）为 IVa 期，5 例（8%）和 5 例（8%）为 IVb 期。组织学检查显示 11 例（19%）A型肿瘤、19 例（30%）AB 型肿瘤、7 例（12%）B1 型肿瘤、11 例（17%）B2 型肿瘤、11 例（17%）B3 型肿瘤和 3 例（5%）C 型肿瘤。辅助治疗包括 3 例（5%）患者化疗和 16 例（26%）患者放疗。中位随访时间为 71 个月（范围 1-145）。48、60 和 72 个月时的 DFS 和 OS 分别为 89%和 89%、86%和 97%以及 95%和 92%。疾病初发时存在重症肌无力（DFS 时 P=0.18；OS 时 P=0.97）和肿瘤直径>5cm（DFS 时 P=0.94；OS 时 P=0.56）并非预后因素。
胸腺瘤是罕见的、惰性肿瘤。完全手术切除后，对于有复发风险的患者采用辅助治疗，如化疗和/或放疗，可获得非常好的 DFS 和 OS 结果，甚至在根治性切除胸膜-肺转移的情况下也是如此。
