Koçer Bulent, Kaplan Tevfik, Günal Nesimi, Koçer Bilge Gönenli, Akkaş Yucel, Yazkan Rasih, Dural Koray, Kulaçoğlu Sezer, Han Serdar
1 Department of Thoracic Surgery, Ankara Numune Teaching and Research Hospital, Ankara, Turkey.
2 Department of Thoracic Surgery, Ufuk University School of Medicine, Ankara, Turkey.
Asian Cardiovasc Thorac Ann. 2018 Jul;26(6):461-466. doi: 10.1177/0218492318778634. Epub 2018 Jun 26.
Background The aim of this study was to evaluate the results of R0 resection of thymoma to identify prognostic factors for long-term outcomes. Methods Data of 62 patients (28 male, 34 female) with a mean age of 47.26 ± 14.42 years, who underwent R0 resection for thymoma and were followed-up between February 2004 and March 2016, were analyzed retrospectively. Results Eight patients had a video-assisted thoracoscopic thymectomy and 54 had a transsternal extended thymectomy. During a mean follow-up of 128.67 ± 7.95 months, regional recurrence of thymoma was observed in 9 (14.5%) patients. Overall 5- and 10-year survival rates were 85.36% and 78.20%, respectively. The 5- and 10-year survival rates in patients aged < 50 years were significantly better than in those aged ≥ 50 years (92% and 72% vs. 88% and 39%, p < 0.0001). The 10-year overall survival of patients in Masaoka stage I and II was better than those in stage III (88.9%, 78.4%, 69.8%, respectively, log-rank p < 0.001). The 10-year survival of patients with World Health Organization histological type A, AB, and B1 thymomas was better than those with type B2 and B3 (log-rank test p < 0.001). In multivariate analysis, age < 50 years ( p = 0.001), Masaoka stage ( p = 0.006), histological type ( p = 0.001), and recurrence ( p = 0.04) were independent prognostic factors for survival. Conclusion Our study indicates that age < 50 years, Masaoka stage, histological type, and recurrence are the determinants of survival in surgically resected cases of thymoma.
背景 本研究旨在评估胸腺瘤R0切除的结果,以确定长期预后的预测因素。方法 回顾性分析2004年2月至2016年3月期间62例接受胸腺瘤R0切除并接受随访的患者(男28例,女34例)的数据,平均年龄47.26±14.42岁。结果 8例行电视辅助胸腔镜胸腺切除术,54例行胸骨正中扩大胸腺切除术。平均随访128.67±7.95个月,9例(14.5%)患者出现胸腺瘤区域复发。总体5年和10年生存率分别为85.36%和78.20%。年龄<50岁患者的5年和10年生存率显著优于年龄≥50岁患者(92%和72% vs. 88%和39%,p<0.0001)。Masaoka I期和II期患者的10年总生存率优于III期患者(分别为88.9%、78.4%、69.8%,log-rank p<0.001)。世界卫生组织组织学类型为A、AB和B1型胸腺瘤患者的10年生存率优于B2和B3型患者(log-rank检验p<0.001)。多因素分析显示,年龄<50岁(p=0.001)、Masaoka分期(p=0.006)、组织学类型(p=0.001)和复发(p=0.04)是生存的独立预测因素。结论 我们的研究表明,年龄<50岁、Masaoka分期、组织学类型和复发是胸腺瘤手术切除病例生存的决定因素。