拉丁美洲胸腺瘤的特征与预后：超过10年经验的结果（CLICaP-LATimus）

Characteristics and outcomes of thymomas in Latin America: Results from over 10 years of experience (CLICaP-LATimus).

作者信息

Martín Claudio, Enrico Diego, Mas Luis, Patane Ana Karina, Arrieta Oscar, Soria Tannia, Cardona Andrés F, Ruiz-Patiño Alejandro, Ruiz Rossana, Rioja Patricia, Lozano Sophia, Zatarain-Barrón Zyanya Lucia, Barrón Feliciano, Puparelli Carmen, Tsou Florencia, Corassa Marcelo P, Freitas Helano C, Cordeiro de Lima Vladmir Cláudio, Rojas Leonardo, Ordóñez-Reyes Camila, Corrales Luis, Sotelo Carolina, Rodríguez July, Ricaurte Luisa, Ávila Jenny, Archila Pilar, Rosell Rafael, Cuello Mauricio, Remon Jordi

机构信息

Thoracic Oncology Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.

Clinical Oncology Department, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.

出版信息

Thorac Cancer. 2021 May;12(9):1328-1335. doi: 10.1111/1759-7714.13901. Epub 2021 Mar 17.

DOI:10.1111/1759-7714.13901

PMID:33729676

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8088938/

Abstract

BACKGROUND

Thymomas are a group of rare neoplasms of the anterior mediastinum. The objective of this study was to describe the demographics, clinical characteristics and treatment approaches in Latin America.

METHODS

This was a retrospective multicenter cohort study including patients with histologically proven thymomas diagnosed between 1997 and 2018. Demographics, clinicopathological characteristics and therapeutic outcomes were collected locally and analyzed in a centralized manner.

RESULTS

A total of 135 patients were included. Median age at diagnosis was 53 years old (19-84), 53.3% (n = 72) of patients were female and 87.4% had an ECOG performance score ranging from 0-1. A total of 47 patients (34.8%) had metastatic disease at diagnosis. Concurrent myasthenia gravis occurred in 21.5% of patients. Surgery was performed in 74 patients (54.8%), comprising 27 (20%) tumorectomies and 47 (34.8%) thymectomies. According to the Masaoka-Koga system, overall survival (OS) at five-years was 73.4%, 63.8% and 51%, at stages I-II, III-IVA and IVB, respectively (p = 0.005). Furthermore, patients with low lactate dehydrogenase (LDH) (≤373 IU/L) at baseline and myasthenia gravis concurrence showed significantly better OS (p = 0.001 and p = 0.008, respectively). In multivariate analysis, high LDH levels (HR 2.8 [95% confidence interval [CI]: 1.1-7.8]; p = 0.036) at baseline and not performing a surgical resection (HR 4.1 [95% CI: 1.3-12.7]; p = 0.016) were significantly associated with increased risk of death.

CONCLUSIONS

Our data provides the largest insight into the clinical characteristics and outcomes of patients with thymomas in Latin America. Survival in patients with thymomas continues to be very favorable, especially when subjected to adequate local control.

摘要

背景

胸腺瘤是一组罕见的前纵隔肿瘤。本研究的目的是描述拉丁美洲胸腺瘤患者的人口统计学特征、临床特点及治疗方法。

方法

这是一项回顾性多中心队列研究，纳入1997年至2018年间经组织学证实的胸腺瘤患者。人口统计学特征、临床病理特征及治疗结果在当地收集并进行集中分析。

结果

共纳入135例患者。诊断时的中位年龄为53岁（19 - 84岁），53.3%（n = 72）的患者为女性，87.4%的患者东部肿瘤协作组（ECOG）体能状态评分为0 - 1分。共有47例患者（34.8%）在诊断时已发生转移。21.5%的患者并发重症肌无力。74例患者（54.8%）接受了手术治疗，其中包括27例（20%）肿瘤切除术和47例（34.8%）胸腺切除术。根据Masaoka - Koga分期系统，I - II期、III - IVA期和IVB期患者的五年总生存率（OS）分别为73.4%、63.8%和51%（p = 0.005）。此外，基线乳酸脱氢酶（LDH）水平低（≤373 IU/L）且并发重症肌无力的患者总生存率显著更高（分别为p = 0.001和p = 0.008）。多因素分析显示，基线LDH水平高（风险比[HR] 2.8 [95%置信区间[CI]：1.1 - 7.8]；p = 0.036）及未进行手术切除（HR 4.1 [95% CI：1.3 - 12.7]；p = 0.016）与死亡风险增加显著相关。