Lee Jun Oh, Lee Geun Dong, Kim Hyeong Ryul, Kim Dong Kwan, Park Seung-Il, Cho Jong Ho, Kim Hong Kwan, Choi Yong Soo, Kim Jhingook, Shim Young Mog, Park Samina, Park In Kyu, Kang Chang Hyun, Kim Young Tae, Park Seong Yong, Lee Chang Young, Lee Jin Gu, Kim Dae Joon, Paik Hyo Chae
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Chest Surg. 2022 Apr 5;55(2):126-142. doi: 10.5090/jcs.21.124.
Thymic epithelial tumors (TETs) are rare, and information regarding their surgical outcomes and prognostic factors has rapidly changed in the past few decades. We analyzed surgical treatment practices for TETs and outcomes in terms of overall survival (OS) and freedom from recurrence (FFR) during a 13-year period in Korea.
In total, 1,298 patients with surgically resected TETs between 2000 and 2013 were enrolled retrospectively. OS and FFR were calculated using the Kaplan-Meier method and evaluated with the log-rank test. Prognostic factors for OS and FFR were analyzed with multivariable Cox regression.
A total of 1,098 patients were diagnosed with thymoma, and 200 patients were diagnosed with thymic carcinoma. Over the study period, the total number of patients with surgically treated TETs and the proportion of patients who underwent minimally invasive thymic surgery (MITS) increased annually. The 5-year and 10-year survival rates of surgically treated TETs were 91.0% and 82.1%, respectively. The 5-year and 10-year recurrence rates were 86.3% and 80.0%, respectively. The outcomes of surgically treated TETs improved over time. Multivariable Cox hazards analysis for OS, age, tumor size, and Masaoka-Koga stage were independent predictors of prognosis. The World Health Organization classification and tumor-node-metastasis (TNM) staging were also related to the prognosis of TETs.
Surgical treatment of TETs achieved a good prognosis with a recent increase in MITS. The M-K stage was the most important prognostic factor for OS and FFR. The new TNM stage could also be an effective predictor of the outcomes of TETs.
胸腺瘤上皮性肿瘤（TETs）较为罕见，在过去几十年里，关于其手术结果和预后因素的信息迅速变化。我们分析了韩国13年间TETs的手术治疗方法以及总生存率（OS）和无复发生存率（FFR）方面的结果。
回顾性纳入了2000年至2013年间1298例接受手术切除的TETs患者。采用Kaplan-Meier法计算OS和FFR，并通过对数秩检验进行评估。采用多变量Cox回归分析OS和FFR的预后因素。
共1098例患者被诊断为胸腺瘤，200例患者被诊断为胸腺癌。在研究期间，接受手术治疗TETs的患者总数以及接受微创胸腺手术（MITS）的患者比例逐年增加。手术治疗TETs的5年和10年生存率分别为91.0%和82.1%。5年和10年复发率分别为86.3%和80.0%。手术治疗TETs的结果随时间有所改善。OS的多变量Cox风险分析显示，年龄、肿瘤大小和Masaoka-Koga分期是预后的独立预测因素。世界卫生组织分类和肿瘤-淋巴结-转移（TNM）分期也与TETs的预后相关。
TETs的手术治疗取得了良好的预后，近期MITS有所增加。M-K分期是OS和FFR最重要的预后因素。新的TNM分期也可能是TETs结果的有效预测指标。
