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胸腺瘤合并重症肌无力患者的长期预后:一项倾向评分匹配分析

Long-term prognosis in patients with thymoma combined with myasthenia gravis: a propensity score-matching analysis.

作者信息

Zhao Kai, Liu Yiming, Jing Miao, Cai Wenhan, Jin Jiamei, Zhu Zirui, Shen Leilei, Wen Jiaxin, Xue Zhiqiang

机构信息

Postgraduate School, Medical School of Chinese PLA, Beijing, China.

Department of Thoracic Surgery, Hainan Hospital of Chinese PLA General Hospital, Sanya, China.

出版信息

Front Med (Lausanne). 2024 Jun 14;11:1407830. doi: 10.3389/fmed.2024.1407830. eCollection 2024.

Abstract

INTRODUCTION

We aimed to assess the impact of myasthenia gravis (MG) on the long-term prognosis in patients with thymoma after surgery and identify related prognostic factors or predictors.

METHODS

This retrospective observational study included 509 patients with thymoma (thymoma combined with MG [MG group] and thymoma alone [non-MG group]). Propensity score matching was performed to obtain comparable subsets of 96 patients in each group. A comparative analysis was conducted on various parameters.

RESULTS

Before matching, the 10-year survival and recurrence-free survival rates in both groups were 93.8 and 98.4%, and 85.9 and 93.4%, respectively, with no statistically significant difference observed in the survival curves between the groups ( > 0.05). After propensity score matching, 96 matched pairs of patients from both groups were created. The 10-year survival and recurrence-free survival rates in these matched pairs were 96.9 and 97.7%, and 86.9 and 91.1%, respectively, with no statistical significance in the survival curves between the groups ( > 0.05). Univariate analysis of patients with thymoma postoperatively revealed that the World Health Organization histopathological classification, Masaoka-Koga stage, Tumor Node Metastasis stage, resection status, and postoperative adjuvant therapy were potentially associated with tumor recurrence after thymoma surgery. Multivariate analysis demonstrated that the Masaoka-Koga stage and postoperative adjuvant therapy independently predicted the risk of recurrence in patients with thymoma after surgery.

CONCLUSION

There was no difference in prognosis in patients with thymoma with or without MG. The Masaoka-Koga stage has emerged as an independent prognostic factor affecting recurrence-free survival in patients with thymoma, while postoperative adjuvant therapy represents a poor prognostic factor.

摘要

引言

我们旨在评估重症肌无力(MG)对胸腺瘤患者术后长期预后的影响,并确定相关的预后因素或预测指标。

方法

这项回顾性观察性研究纳入了509例胸腺瘤患者(胸腺瘤合并MG[MG组]和单纯胸腺瘤[非MG组])。进行倾向评分匹配以获得每组96例具有可比性的亚组。对各种参数进行了比较分析。

结果

匹配前,两组的10年生存率和无复发生存率分别为93.8%和98.4%,以及85.9%和93.4%,两组生存曲线间无统计学显著差异(>0.05)。倾向评分匹配后,两组创建了96对匹配患者。这些匹配对的10年生存率和无复发生存率分别为96.9%和97.7%,以及86.9%和91.1%,两组生存曲线间无统计学意义(>0.05)。对胸腺瘤术后患者的单因素分析显示,世界卫生组织组织病理学分类、Masaoka-Koga分期、肿瘤淋巴结转移分期、切除状态和术后辅助治疗可能与胸腺瘤手术后肿瘤复发相关。多因素分析表明,Masaoka-Koga分期和术后辅助治疗独立预测胸腺瘤术后患者的复发风险。

结论

伴有或不伴有MG的胸腺瘤患者预后无差异。Masaoka-Koga分期已成为影响胸腺瘤患者无复发生存的独立预后因素,而术后辅助治疗是不良预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daa1/11211277/b8beda691c59/fmed-11-1407830-g001.jpg

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