Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
Thorac Cancer. 2018 Jan;9(1):88-93. doi: 10.1111/1759-7714.12542. Epub 2017 Oct 31.
Thymic complete resection is considered the standard treatment for all thymic tumors; however, the ideal resection for non-myasthenic early stage thymic tumors has not yet been determined. We conducted a retrospective study to examine this unique scenario.
We retrospectively analyzed the data of 118 early stage thymoma patients who underwent thymectomy (TM) or thymomectomy (TMM) with curative intent between January 2003 and December 2013 at our institution. Patients with myasthenia, thymic carcinomas, tumors with undetermined histology, and more advanced stage thymoma patients were excluded. We compared overall survival (OS) and disease-free survival (DFS) according to the extent of thymic resection, tumor staging, and size.
One hundred and eighteen patients were staged as early thymoma. TM was performed in 43 (35.6%) patients and TMM in 75 (64.4%). Forty-nine (65.3%) patients with a tumor ≤ 3 cm underwent TMM, and 9 (20.9%) TM. Twenty-six (34.7%) patients with a tumor > 3 cm underwent TMM, and 34 (79.1%) TM. Seventy-four patients were categorized as stage I: 57 (76%) underwent TMM and 17 (39.5%) TM. Forty-four patients were categorized as stage II: 18 (24%) underwent TMM and 26 (60.5%) TM. There was no statistically significant difference in recurrence between the groups (P = 0.250).
No difference in the rate of recurrence was observed in early stage non-myasthenic patients following thymic resection and Masaoka-Koga staging. However, TM is considered a better option for early stage thymoma patients with tumors > 3 cm.
胸腺完全切除术被认为是所有胸腺瘤的标准治疗方法；然而，非重症肌无力早期胸腺瘤的理想切除术尚未确定。我们进行了一项回顾性研究来探讨这一独特的情况。
我们回顾性分析了 2003 年 1 月至 2013 年 12 月期间在我院接受以治愈为目的的胸腺切除术（TM）或胸腺肿瘤切除术（TMM）的 118 例早期胸腺瘤患者的数据。排除重症肌无力、胸腺癌、组织学未确定的肿瘤和更晚期的胸腺瘤患者。我们根据胸腺切除范围、肿瘤分期和大小比较了总生存率（OS）和无病生存率（DFS）。
118 例患者被分期为早期胸腺瘤。43 例（35.6%）患者行 TM，75 例（64.4%）行 TMM。49 例肿瘤直径≤3cm 的患者行 TMM，9 例行 TM。26 例肿瘤直径>3cm 的患者行 TMM，34 例行 TM。74 例患者被归类为 I 期：57 例（76%）行 TMM，17 例（39.5%）行 TM。44 例患者被归类为 II 期：18 例（24%）行 TMM，26 例（60.5%）行 TM。两组之间复发率无统计学差异（P=0.250）。
在非重症肌无力的早期患者中，胸腺切除和 Masaoka-Koga 分期后，复发率没有差异。然而，对于肿瘤直径>3cm 的早期胸腺瘤患者，TM 被认为是更好的选择。
