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[手术治疗淋巴上皮性胸腺瘤的长期生存情况]

[Long-term survival of surgically treated lympho-epithelial thymomas].

作者信息

Dahan M, Gaillard J, Mary H, Renella-Coll J, Berjaud J

机构信息

Service de chirurgie thoracique, Hôpital Purpan, Toulouse.

出版信息

Rev Mal Respir. 1988;5(2):159-65.

PMID:3393710
Abstract

The authors report the results of a multi-centre trial on 500 cases of lymph-epithelial thymoma (TLE) treated by 14 surgical teams. Most typically a tumour of the adult in the fifth decade, occurring most commonly in women (60%), one in every two cases of TLE occurs in auto-immune disease: usually myasthenia. Most often (3 times out of 4) the disease is latent and occupies the middle (40%) or superior mediastinum (30%). In 15% of cases the pulmonary radiograph is normal. Radical surgery is possible in 75% of cases, otherwise it is incomplete or even reduced to a simple biopsy. The 15 year prognosis obtained using actuarial survival curves is based on the surgical-anatomical classification of the study group of thymic tumours (GETT) giving: for stage I: a survival of 80% for stage II to IVA of 40% and for stages III to IVB of around 10%. Finally it should be noted that existence of a recurrence after a complete surgical excision (stage I) poses the problem of post-operative radiotherapy and the associated total thymectomy. Also, the identical prognosis after biopsy or incomplete surgery (IIIA and IIIB) with an increased morbidity for incomplete surgery. Finally the confirmation that pleural involvement (IVA) is not as adverse a factor as one would have supposed.

摘要

作者报告了由14个手术团队对500例淋巴上皮性胸腺瘤(TLE)进行的多中心试验结果。TLE最典型的是成人在五十多岁时患的肿瘤,最常见于女性(60%),每两例TLE中就有一例发生在自身免疫性疾病中:通常是重症肌无力。该疾病大多时候(四分之三)处于潜伏状态,位于中纵隔(40%)或上纵隔(30%)。15%的病例胸部X光片正常。75%的病例可行根治性手术,否则手术不完整,甚至只能进行简单活检。使用精算生存曲线得出的15年预后是基于胸腺肿瘤研究组(GETT)的手术解剖分类,结果如下:I期生存率为80%,II至IVA期为40%,III至IVB期约为10%。最后需要指出的是,完全手术切除(I期)后出现复发会带来术后放疗及相关全胸腺切除术的问题。此外,活检或不完全手术(IIIA和IIIB)后的预后相同,但不完全手术的发病率更高。最后证实胸膜受累(IVA)并非如人们原本认为的那样是一个不利因素。

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