Tamburini Nicola, Maniscalco Pio, Migliorelli Andrea, Nigim Fares, Quarantotto Francesco, Maietti Elisa, Cavallesco Giorgio
Department of Morfology, Experimental Medicine and Surgery, Section of General and Thoracic Surgery, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy.
Division of Neurosurgery, Department of Surgery, Harvard Medical School, Boston, Massachusetts, United States.
Thorac Cardiovasc Surg. 2020 Aug;68(5):433-439. doi: 10.1055/s-0039-1678612. Epub 2019 Feb 22.
This study aims to describe the relationship between the new tumor nodes metastasis (TNM) staging and World Health Organization (WHO) classification and to identify how these two variables relate to each other and whether they possess a prognostic value in predicting survival and recurrence of disease.
Medical records of 54 patients who underwent surgery for thymic epithelial tumors between 1996 and 2015 were reviewed.The histologic type of neoplasm was classified according to the criteria of WHO and staging was evaluated using the new TNM classification system.
A significant correlation between the TNM stages and the histological classification was found ( < 0.001). Complete resection is related to both TNM stage and histological grading ( < 0.001). Evaluation of the 5- and 10-year survival curves shows how these are significantly correlated only at the stage ( = 0.03 and = 0.04, respectively). The risk of death at 5 and 10 years for stages III to IV is six and three times higher than in stages I to II, respectively. Regarding the disease-free survival, there is significant correlation with both staging and histology ( = 0.001 and = 0.02, respectively).
There is a significant correlation between the new TNM staging and the histological grade WHO. The ability to implement a complete resection, the overall and disease-free survival is closely related to the thymoma stage. Furthermore, both histotype and stage correlate with disease-free survival. In fact, the least aggressive stages, both WHO and TNM, have a free time out of disease superior to advanced stages.
本研究旨在描述新的肿瘤淋巴结转移（TNM）分期与世界卫生组织（WHO）分类之间的关系，并确定这两个变量如何相互关联，以及它们在预测疾病生存和复发方面是否具有预后价值。
回顾了1996年至2015年间接受胸腺上皮肿瘤手术的54例患者的病历。根据WHO标准对肿瘤的组织学类型进行分类，并使用新的TNM分类系统评估分期。
发现TNM分期与组织学分类之间存在显著相关性（<0.001）。完整切除与TNM分期和组织学分级均相关（<0.001）。对5年和10年生存曲线的评估显示，这些仅在分期时显著相关（分别为=0.03和=0.04）。III至IV期5年和10年的死亡风险分别比I至II期高6倍和3倍。关于无病生存期，与分期和组织学均存在显著相关性（分别为=0.001和=0.02）。
新的TNM分期与WHO组织学分级之间存在显著相关性。实施完整切除的能力、总生存期和无病生存期与胸腺瘤分期密切相关。此外，组织学类型和分期均与无病生存期相关。事实上，WHO和TNM中侵袭性最小的分期，其无病时间优于晚期。
