Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
J Thorac Oncol. 2021 Nov;16(11):1936-1945. doi: 10.1016/j.jtho.2021.07.004. Epub 2021 Jul 10.
The International Thymic Malignancy Interest Group (ITMIG) classifies thymoma recurrences on the basis of the topographic location, but its effectiveness in prognosis prediction has not been well investigated yet. Aims of this study are to analyze survival outcome of patients surgically treated for thymoma recurrence according to the ITMIG recurrence classification and to investigate possible alternatives.
From January 1, 1990, to January 7, 2017, data on 135 surgically treated patients for thymoma recurrence from three high-volume centers were collected and retrospectively analyzed. Patients were classified according to the ITMIG classification as local, regional, and distant. The ITMIG classification and alternative classifications were correlated to overall survival (OS).
According to the ITMIG classification, recurrence was local in 17 (12.5%), regional in 97 (71.8%), and distant in 21 (15.7%) patients, with single localization in 38 (28.2%) and multiple localizations in 97 (71.8%). The 5- and 10-year OS were 79.9% and 49.7% in local, 68.3% and 52.6% in regional, and 66.3% and 35.4% in distant recurrences, respectively, but differences were not statistically significant (p = 0.625). A significant difference in survival was present considering single versus multiple localizations: 5- and 10-year OS of 86.2% and 81.2% versus 61.3% and 31.5% (p = 0.005, hazard ratio = 7.22, 95% confidence interval: 0.147-0.740), respectively. Combining the localization number with the recurrence site, ITMIG locoregional single recurrence had a statistically significant better survival compared with patients with ITMIG locoregional multiple recurrence or ITMIG distant recurrence (p = 0.028). Similarly, a significant difference was present considering intrathoracic single versus intrathoracic multiple versus distant recurrence (p = 0.024).
The ITMIG classification for thymoma recurrence did not have significant survival differences comparing local, regional, and distant recurrences. Integrating this classification with the number of the localizations may improve its effectiveness in prognosis prediction.
国际胸腺癌兴趣小组（ITMIG）根据肿瘤的位置对胸腺瘤复发进行分类，但它在预测预后方面的有效性尚未得到很好的研究。本研究的目的是根据 ITMIG 复发分类分析接受手术治疗的胸腺瘤复发患者的生存结果，并探讨可能的替代方案。
从 1990 年 1 月 1 日至 2017 年 1 月 7 日，收集了来自三个高容量中心的 135 例手术治疗的胸腺瘤复发患者的数据，并进行回顾性分析。患者根据 ITMIG 分类分为局部、区域和远处复发。将 ITMIG 分类与其他分类与总生存率（OS）相关联。
根据 ITMIG 分类，17 例（12.5%）患者局部复发，97 例（71.8%）区域复发，21 例（15.7%）远处复发，38 例（28.2%）单发，97 例（71.8%）多发。局部、区域和远处复发的 5 年和 10 年 OS 分别为 79.9%和 49.7%、68.3%和 52.6%、66.3%和 35.4%，但差异无统计学意义（p=0.625）。考虑到单发与多发的定位数量，生存差异具有统计学意义：5 年和 10 年 OS 分别为 86.2%和 81.2%与 61.3%和 31.5%（p=0.005，风险比=7.22，95%置信区间：0.147-0.740）。将定位数量与复发部位相结合，ITMIG 局部区域单发复发与 ITMIG 局部区域多发复发或 ITMIG 远处复发患者的生存情况有统计学显著差异（p=0.028）。同样，胸内单发与胸内多发与远处复发相比，差异具有统计学意义（p=0.024）。
ITMIG 对胸腺瘤复发的分类在局部、区域和远处复发之间没有显著的生存差异。将这种分类与定位数量相结合可能会提高其在预后预测方面的有效性。
