Yang Xudong, Zhao Kejia, Li Chuan, Yang Yanbo, Guo Chenglin, Pu Yi, Liu Lunxu
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China.
Front Oncol. 2020 Dec 22;10:592023. doi: 10.3389/fonc.2020.592023. eCollection 2020.
Thymic squamous cell carcinoma (TSCC) is a rare neoplasm that has been sparsely cited in the literature. The aim of this study was to determine disease characteristics and prognostic factors of patients in a Surveillance, Epidemiology, and End Results (SEER) analysis.
Cases from 1990-2016 were retrieved from the SEER database and demographics, treatments, and survival outcomes were analyzed.
The TSCC accounted for 72.4% of the thymic carcinomas and 7.2% of thymic tumors. The 276 patients (165 men) selected for analysis had a median age of 65 (24-85) years, and 201 patients were diagnosed with Masaoka-Koga stage III/IV. The median survival of TSCC was 59 months with a 49.0% 5-year OS rate, a better prognosis than lymphoepithelioma-like carcinoma (32.1%) and undifferentiated carcinoma (33.3%). Multivariate analysis revealed the Masaoka-Koga stage (p = 0.003) and surgical types (complete resection, incomplete resection, and none; p < 0.001) were determinants of survival. Complete resection had the best prognosis with a 72.7% 5-year OS rate. Chemotherapy was an independent protective factor (HR = 0.555, 95% CI 0.347-0.886; p = 0.014) though poor survival was showed in univariate analysis. And the survival benefit of chemotherapy was validated in PSM analysis (3-year OS rate was 77.7% with chemotherapy 52.8% without chemotherapy; p = 0.014).
TSCC was frequently diagnosed in older patients with advanced Masaoka-Koga stage and had more favorable survival than other subtypes of thymic carcinomas. Complete resection is the preferred treatment. Masaoka-Koga stage and chemotherapy had a strong association with prognosis.
胸腺鳞状细胞癌（TSCC）是一种罕见肿瘤，在文献中鲜有报道。本研究旨在通过监测、流行病学和最终结果（SEER）分析确定患者的疾病特征和预后因素。
从SEER数据库中检索1990 - 2016年的病例，并分析人口统计学、治疗方法和生存结果。
TSCC占胸腺癌的72.4%，占胸腺肿瘤的7.2%。入选分析的276例患者（165例男性）中位年龄为65岁（24 - 85岁），201例患者诊断为Masaoka - Koga III/IV期。TSCC的中位生存期为59个月，5年总生存率为49.0%，预后优于淋巴上皮瘤样癌（32.1%）和未分化癌（33.3%）。多因素分析显示，Masaoka - Koga分期（p = 0.003）和手术类型（完全切除、不完全切除和未手术；p < 0.001）是生存的决定因素。完全切除预后最佳，5年总生存率为72.7%。化疗是独立的保护因素（HR = 0.555，95%CI 0.347 - 0.886；p = 0.014），尽管单因素分析显示生存情况较差。化疗的生存获益在倾向评分匹配（PSM）分析中得到验证（化疗组3年总生存率为77.7%，未化疗组为52.8%；p = 0.014）。
TSCC常见于Masaoka - Koga分期较晚的老年患者，其生存情况优于其他胸腺癌亚型。完全切除是首选治疗方法。Masaoka - Koga分期和化疗与预后密切相关。
