Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
Thorac Cancer. 2017 Sep;8(5):402-409. doi: 10.1111/1759-7714.12448. Epub 2017 Jun 13.
A giant thoracic neoplasm is extremely rare and poorly understood. Our systemic study introduced computed tomography angiography (CTA) with three-dimensional (3D) reconstruction imaging and evaluated correlations between imaging, pathology, and surgical management.
Data from 45 patients undergoing surgery for giant thoracic neoplasm in our institution between May 2007 and November 2015 were collected. The clinical characteristics, imaging manifestations, preoperative biopsy, surgical management, postoperative pathology, and prognosis and their correlation were analyzed.
The clinical characteristics, imaging manifestations, and pathological types were complicated. Four patients underwent CTA with 3D reconstruction imaging and feeding vessels were found in three cases. Twenty-four selected patients accepted preoperative biopsy, eight of which were inconsistent with postoperative pathology. Complete resection was performed in 39 cases, 20 of which underwent extended excision. The median survival duration of all patients was 58 months (range 3.0-118.0). The one, three, and five-year survival rates were 86.0%, 64.4%, and 47.0%, respectively. Univariate analyses showed tumor size and resection status were prognostic factors for survival (P = 0.003 and P < 0.001, respectively).
A giant thoracic neoplasm should preferably be treated in experienced centers for precise diagnosis and optimal therapy schemes with comprehensive consideration of clinical characters, imaging manifestations, pathology, surgical management, and prognosis. Innovative CTA with 3D reconstruction imaging together with preoperative biopsy are feasible and effective in therapeutic decision-making and surgical planning. Complete surgical resection remains the mainstay of curative therapy for all resectable tumors.
巨大的胸部肿瘤极其罕见，目前了解甚少。我们的系统研究介绍了计算机断层血管造影（CTA）三维（3D）重建成像，并评估了影像学、病理学和手术管理之间的相关性。
收集 2007 年 5 月至 2015 年 11 月期间在我院接受巨大胸部肿瘤手术的 45 例患者的数据。分析患者的临床特征、影像学表现、术前活检、手术管理、术后病理、预后及其相关性。
患者的临床特征、影像学表现和病理类型复杂多样。4 例患者接受了 CTA 三维重建成像，其中 3 例发现了供血血管。24 例患者选择了术前活检，其中 8 例与术后病理不符。39 例患者行完全切除术，其中 20 例患者行扩大切除术。所有患者的中位生存时间为 58 个月（范围 3.0-118.0）。患者的 1、3 和 5 年生存率分别为 86.0%、64.4%和 47.0%。单因素分析显示肿瘤大小和切除状态是影响生存的预后因素（P=0.003 和 P<0.001）。
巨大的胸部肿瘤应在有经验的中心进行治疗，以便进行精确诊断和制定最佳治疗方案，综合考虑临床特征、影像学表现、病理学、手术管理和预后。创新的 CTA 三维重建成像与术前活检相结合，在治疗决策和手术规划方面是可行和有效的。完全手术切除仍然是所有可切除肿瘤的主要治疗方法。
