Dharanikota Anvesh, Arjunan Ravi, Chowdappa Ramachandra, Althaf Syed
Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Marigowda Road, Bangalore, Karnataka India.
Indian J Surg Oncol. 2020 Dec;11(4):785-790. doi: 10.1007/s13193-020-01258-5. Epub 2020 Nov 20.
Thymomas are relatively slow growing with late presentation. Because of rarity and underreporting in India, there is an unmet need for evaluating the patient characteristics and assessing the factors affecting survival for standardizing the ideal modality of treatment in Indian population. A retrospective analysis of 96 patients with thymoma was done between 1998 and 2018. Patient characteristics, histopathological characteristics, operative outcomes, local recurrences, and survival outcomes were recorded. Survival analysis was done using Kaplan-Meier method, and statistical data were analyzed using SPSS version 25 (IBM). The incidence of thymoma was relatively high in 6th decade with no sex predilection. Common presenting symptoms were cough and dyspnea. Myasthenia gravis was noted in 30.2%, which resolved after thymectomy in 65.5% of patients. Most patients presented with Masaoka stages I and II, and predominant WHO histological types were B1 and AB. Complete resection was done in 69.8% cases, and local recurrence was noted in 15.6%. Median sternotomy was the most frequently used approach for thymectomy. The 5-year overall survival was 76%, with an excellent 5-year survival of 95% and 86% in stages I and II patients. Masaoka stage, WHO histologic type, completeness of surgery, and local recurrence did affect the survival significantly. Masaoka stages III and IV, histological type B3, incomplete resection during surgery, and presence of local recurrence did independently predict a worse overall survival.
胸腺瘤生长相对缓慢，症状出现较晚。由于在印度胸腺瘤较为罕见且报告不足，因此在评估患者特征以及评估影响生存的因素以规范印度人群理想的治疗方式方面存在未满足的需求。对1998年至2018年间的96例胸腺瘤患者进行了回顾性分析。记录了患者特征、组织病理学特征、手术结果、局部复发情况和生存结果。使用Kaplan-Meier方法进行生存分析，并使用SPSS 25版（IBM）对统计数据进行分析。胸腺瘤的发病率在第六个十年相对较高，无性别倾向。常见的症状为咳嗽和呼吸困难。30.2%的患者出现重症肌无力，其中65.5%的患者在胸腺切除术后症状缓解。大多数患者表现为Masaoka分期I和II期，世界卫生组织（WHO）主要组织学类型为B1和AB型。69.8%的病例进行了完整切除，15.6%的患者出现局部复发。正中胸骨切开术是胸腺切除术最常用的方法。5年总生存率为76%，I期和II期患者的5年生存率分别高达95%和86%。Masaoka分期、WHO组织学类型、手术完整性和局部复发对生存有显著影响。Masaoka III期和IV期、组织学类型B3、手术切除不完全以及存在局部复发独立预测总体生存率较差。
