Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, Jilin, 130021, China.
Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital, Shandong First Medical University, Jinan, 250021, Shandong, China.
Sci Rep. 2024 Nov 12;14(1):27680. doi: 10.1038/s41598-024-79186-5.
This study aims to clarify the impact of tumor size on the prognosis of patients diagnosed with thymoma and thymic carcinoma, leveraging data from a population-based registry. Utilizing the SEER database, this retrospective analysis identified patients diagnosed with thymoma and thymic carcinoma from 2000 to 2020. Propensity score matching was employed to mitigate potential statistical biases between groups categorized by tumor size (≤ 6.5 cm and > 6.5 cm). The study included a total of 3857 patients, comprising 2688 with thymoma and 1169 with thymic carcinoma. Multivariate analysis demonstrated that tumors ≤ 6.5 cm independently correlated with improved Cancer-Specific Survival (CSS) (p = 0.001; p < 0.001) and Overall Survival (OS) (p < 0 .001; p < 0.001) in both thymoma and thymic carcinoma cohorts. Subgroup analysis revealed that smaller tumors (≤ 6.5 cm) conferred survival benefits in patients with Masaoka-Koga stage IIB thymomas and stage III/IV thymic carcinomas (thymoma: CSS: p < 0.0001; OS: p = 0.00045; thymic carcinoma: CSS: p = 0.028; OS: p = 0.014). Additionally, WHO type A/AB/B1 and type B2/B3 thymomas with tumors ≤ 6.5 cm exhibited superior CSS (p = 0.005; p < 0.00018) and OS (p = 0.015; p = 0.0021). Through propensity matching analysis utilizing the SEER database, this study underscores the prognostic significance of tumor size in both early-stage thymoma and advanced-stage thymic carcinoma, identifying a critical threshold of 6.5 cm. In the WHO classification, tumor size based on the cut-off value of 6.5 cm has a greater impact on the prognosis of type B2/B3 (high-risk group) than A/AB/B1 (low-risk group).
本研究旨在利用基于人群的登记处的数据，阐明肿瘤大小对胸腺瘤和胸腺癌患者预后的影响。本回顾性分析利用 SEER 数据库，确定了 2000 年至 2020 年间诊断为胸腺瘤和胸腺癌的患者。采用倾向评分匹配法，以减轻按肿瘤大小（≤6.5cm 和>6.5cm）分组的潜在统计学偏倚。本研究共纳入 3857 例患者，其中 2688 例为胸腺瘤患者，1169 例为胸腺癌患者。多变量分析表明，肿瘤≤6.5cm 与胸腺瘤和胸腺癌患者的癌症特异性生存（CSS）（p=0.001;p<0.001）和总生存（OS）（p<0.001;p<0.001）的改善独立相关。亚组分析显示，在 Masaoka-Koga 分期 IIB 胸腺瘤和 III/IV 期胸腺癌患者中，较小肿瘤（≤6.5cm）可带来生存获益（胸腺瘤：CSS：p<0.0001；OS：p=0.00045；胸腺癌：CSS：p=0.028；OS：p=0.014）。此外，肿瘤≤6.5cm 的 WHO 型 A/AB/B1 和型 B2/B3 胸腺瘤的 CSS（p=0.005;p<0.00018）和 OS（p=0.015;p=0.0021）也更好。本研究通过利用 SEER 数据库进行倾向评分匹配分析，强调了肿瘤大小在早期胸腺瘤和晚期胸腺癌中的预后意义，并确定了 6.5cm 的关键阈值。在 WHO 分类中，基于 6.5cm 截断值的肿瘤大小对 B2/B3（高危组）的预后影响大于 A/AB/B1（低危组）。
