Department of Thoracic Surgery, University of Torino, Torino, Italy.
Department of Thoracic Surgery, St. James's University Hospital, Leeds, UK.
Eur J Cardiothorac Surg. 2019 Apr 1;55(4):601-609. doi: 10.1093/ejcts/ezy448.
We queried the European Society of Thoracic Surgeons (ESTS) prospective thymic database for descriptive analysis and for comparison with the ESTS retrospective thymic database (1990-2010).
Data were retrieved (January 2007-November 2017) for 1122 patients from 75 ESTS institutions.
There were 484 (65%) thymomas, 207 (28%) thymic carcinomas and 49 (7%) neuroendocrine thymic tumours. Staging (Masaoka) included 483 (67%) stage I and II, 100 (14%) stage III and 70 (10%) stage IV tumours. The new International Association for the Study of Lung Cancer/International Thymic Malignancies Interest Group tumour, node and metastasis (TNM) classification was available for 224 patients and including 177 (85%) stage I-II, 37 (16%) stage IIIA and 10 (4%) stage IIIB tumours. Chemotherapy as induction and adjuvant treatment was used in 14% and 15% of the patients. Radiotherapy was almost exclusively used postoperatively (24%). A minimally invasive surgical approach (video-assisted thoracic surgery/robotic-assisted thoracic surgery) was used in 276 (33%) patients. The overall recurrence rate was 10.8% (N = 38). Compared to the ESTS retrospective database, the increased prevalence of thymic carcinomas (from 9% to 28%) and neuroendocrine thymic tumours (from 2% to 7%), an increase in the use of minimally invasive techniques (from 6% to 34%) and a wider use of chemotherapy as induction (from 9% to 15%) and adjuvant (from 2% to 16%) treatment were observed in the prospective database. The introduction of a set of variables considered essential for the data use ('minimum dataset') resulted in an increased average completeness rate.
The reported data from the ESTS prospective thymic database confirm the recent trends in the management of thymic tumours. The ESTS prospective thymic database represents a powerful resource open to all ESTS members for the global effort to manage these rare tumours.
我们查询欧洲胸外科协会（ESTS）前瞻性胸腺瘤数据库，进行描述性分析，并与 ESTS 回顾性胸腺瘤数据库（1990-2010 年）进行比较。
从 75 个 ESTS 机构中检索了 1122 例患者的数据（2007 年 1 月至 2017 年 11 月）。
其中胸腺瘤 484 例（65%），胸腺癌 207 例（28%），神经内分泌胸腺瘤 49 例（7%）。分期（Masaoka）包括 I 期和 II 期 483 例（67%），III 期 100 例（14%）和 IV 期 70 例（10%）。224 例患者可获得新的国际肺癌研究协会/国际胸内恶性肿瘤兴趣小组肿瘤、淋巴结和转移（TNM）分期，包括 I-II 期 177 例（85%），IIIA 期 37 例（16%）和 IIIB 期 10 例（4%）。14%和 15%的患者接受诱导和辅助化疗。术后几乎均采用放疗（24%）。276 例（33%）患者采用微创外科方法（电视辅助胸腔镜手术/机器人辅助胸腔镜手术）。总的复发率为 10.8%（N=38）。与 ESTS 回顾性数据库相比，前瞻性数据库中胸腺癌（从 9%到 28%）和神经内分泌胸腺瘤（从 2%到 7%）的患病率增加，微创技术的应用增加（从 6%到 34%），诱导化疗（从 9%到 15%）和辅助化疗（从 2%到 16%）的应用增加。引入一套被认为是数据使用所必需的变量（“最小数据集”）后，平均完整性率提高。
ESTS 前瞻性胸腺瘤数据库报告的数据证实了胸腺瘤治疗的最新趋势。ESTS 前瞻性胸腺瘤数据库是 ESTS 所有成员用于管理这些罕见肿瘤的全球努力的有力资源。
