Department of Thoracic Surgery, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Department of Thoracic Surgery, Nishi-Kobe Medical Center, 5-7-1 Koujidai, Nishi-ku, Kobe, 651-2273, Japan.
Surg Today. 2021 Apr;51(4):502-510. doi: 10.1007/s00595-020-02102-7. Epub 2020 Aug 10.
There are few data available on the outcomes of postoperative recurrent thymic carcinoma (TC) and thymic neuroendocrine carcinoma (TNEC). The aim of this study is to evaluate the treatment and survival in patients with recurrent TC and TNEC after undergoing surgical resection.
A retrospective chart review was performed using our multicenter database to identify patients with a postoperative recurrence of TC and TNEC from 1995 to 2018. The clinicopathological factors were reviewed and the survival outcomes were analyzed.
Sixty patients were identified among 152 patients who underwent resection of TC and TNEC. The median follow-up period from the first recurrence was 14.8 months (range 0-144). The 5-year post-recurrence survival was 23% for the whole cohort. According to a univariable analysis, advanced stage [hazard ratio (HR) 2.81, 95% confidence interval (CI) 1.09-9.54], interval between primary surgery and recurrence (HR 0.97, 95% CI 0.95-0.99), any treatment for recurrence (HR: 0.27, 95% CI 0.13-0.58) and chemotherapy for recurrence (HR: 0.46, 95% CI 0.22-0.95) were significant factors related to post-recurrence survival.
Chemotherapy rather than surgery appears to be the mainstay treatment for managing patients with postoperative recurrent TC and TNEC and it may also be considered in multidisciplinary management. Further studies with a larger sample size are required to confirm our findings.
关于胸腺癌(TC)和胸腺神经内分泌癌(TNEC)术后复发的结果,数据有限。本研究旨在评估接受手术切除后 TC 和 TNEC 术后复发患者的治疗和生存情况。
使用我们的多中心数据库进行回顾性图表审查,以确定 1995 年至 2018 年期间 TC 和 TNEC 术后复发的患者。回顾临床病理因素并分析生存结果。
在 152 例接受 TC 和 TNEC 切除的患者中,确定了 60 例患者。首次复发后中位随访时间为 14.8 个月(范围 0-144)。整个队列的 5 年复发后生存率为 23%。根据单变量分析,晚期分期[风险比(HR)2.81,95%置信区间(CI)1.09-9.54]、原发性手术与复发之间的间隔(HR 0.97,95%CI 0.95-0.99)、任何针对复发的治疗(HR:0.27,95%CI 0.13-0.58)和针对复发的化疗(HR:0.46,95%CI 0.22-0.95)是与复发后生存相关的显著因素。
与手术相比,化疗似乎是治疗 TC 和 TNEC 术后复发患者的主要治疗方法,也可在多学科管理中考虑。需要进一步的研究来证实我们的发现。