Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Department of Endocrinology (AS), Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
Clin Neurol Neurosurg. 2020 Sep;196:106056. doi: 10.1016/j.clineuro.2020.106056. Epub 2020 Jun 29.
Thymomas are rare in clinical practice, and cases of metastatic spinal thymoma are extremely scarce, with only a few case reports or case series described in the literature. In this study, we characterized the clinical features, treatment options and prognostic analysis of patients with metastatic spinal thymomas.
This study included seven patients with metastatic spinal thymoma who underwent open surgery or minimally invasive surgery, and adjuvant treatment in a single center of Peking Union Medical College Hospital from 2010 to 2019. The basic clinical data of the patients were analyzed retrospectively. The possible prognostic factors of progression-free survival (PFS) and overall survival (OS) were studied using the Kaplan-Meier method.
This retrospective study included six male patients and one female patient, with a median age of 58.4 (47-75) years. The time from initial diagnosis to detection of spinal metastasis was 54.2 (30-108) months. Kaplan-Meier survival analysis showed the number of spinal metastasis and adjuvant therapies were favorable factors for improving OS and PFS in patients with metastatic spinal thymomas.
Radiation therapy after the primary operation is an efficient adjuvant therapy, since patients who received postoperative radiation treatment have longer OS and PFS than those who receive chemoradiotherapy. The number of spinal metastases seems to be an effective prognostic factor for longer OS and PFS of patients with spinal metastasis of thymoma.
胸腺瘤在临床上较为罕见,而发生脊髓转移的胸腺瘤则更为罕见,文献中仅有少数病例报告或病例系列报道。本研究旨在对发生脊髓转移的胸腺瘤患者的临床特征、治疗选择和预后分析进行总结。
本研究纳入了 2010 年至 2019 年期间在我院单一中心接受开放手术或微创手术以及辅助治疗的 7 例发生脊髓转移的胸腺瘤患者。回顾性分析患者的基本临床资料,采用 Kaplan-Meier 法研究无进展生存(progression-free survival,PFS)和总生存(overall survival,OS)的可能预后因素。
本回顾性研究共纳入 6 例男性和 1 例女性患者,中位年龄为 58.4(47-75)岁。从初始诊断到发现脊髓转移的时间为 54.2(30-108)个月。Kaplan-Meier 生存分析显示,脊髓转移的数量和辅助治疗是影响发生脊髓转移的胸腺瘤患者 OS 和 PFS 的有利因素。
原发性手术后的放疗是一种有效的辅助治疗手段,因为接受术后放疗的患者的 OS 和 PFS 长于接受放化疗的患者。脊髓转移的数量似乎是影响胸腺瘤脊髓转移患者 OS 和 PFS 的有效预后因素。