Maggi G, Giaccone G, Donadio M, Ciuffreda L, Dalesio O, Leria G, Trifiletti G, Casadio C, Palestro G, Mancuso M
Cancer. 1986 Aug 1;58(3):765-76. doi: 10.1002/1097-0142(19860801)58:3<765::aid-cncr2820580326>3.0.co;2-s.
One hundred sixty-five patients with surgically treated thymoma were followed over 28 years; 73% had myasthenia gravis at presentation. Invasiveness was based on macroscopic findings at operation. Postsurgical radiotherapy or chemotherapy were not routinely used. Overall survival was 84%, 79%, and 65% at 3, 5, and 10 years, respectively. Patients with invasive thymoma survived for a shorter period than patients with noninvasive tumors (67% versus 85% at 5 years); when radical excision was possible, no difference was detectable between the two groups. Patients with subtotally resected or only biopsied invasive thymomas survived 59% and 42% at 5 years, respectively. Lymphoepithelial cases had the worst prognosis of the histologic types considered. Myasthenia gravis did not adversely affect survival. Surgery is the basic treatment of thymomas. Macroscopic invasiveness and degree of excision judged by the surgeon have prognostic value and are reliable criteria of malignancy. Radiotherapy and chemotherapy may be effective, but their use should be limited to controlled trials.
165例接受胸腺肿瘤手术治疗的患者接受了长达28年的随访；73%的患者在就诊时患有重症肌无力。侵袭性基于手术中的宏观发现。术后放疗或化疗未常规使用。3年、5年和10年的总生存率分别为84%、79%和65%。侵袭性胸腺瘤患者的生存期比非侵袭性肿瘤患者短（5年时分别为67%和85%）；当可以进行根治性切除时，两组之间没有可检测到的差异。次全切除或仅活检的侵袭性胸腺瘤患者5年生存率分别为59%和42%。在考虑的组织学类型中，淋巴上皮病例的预后最差。重症肌无力对生存率没有不利影响。手术是胸腺瘤的基本治疗方法。外科医生判断的宏观侵袭性和切除程度具有预后价值，是恶性肿瘤的可靠标准。放疗和化疗可能有效，但它们的使用应限于对照试验。
