Shamji F, Pearson F G, Todd T R, Ginsberg R J, Ilves R, Cooper J D
J Thorac Cardiovasc Surg. 1984 Jan;87(1):43-7.
Ten years' experience with surgical treatment of thymoma in 52 patients is reported, 25 patients with myasthenia gravis and 27 without. Twenty-five patients had noninvasive tumors (Stage I) and 27 had invasive tumors (Stages II and III). Of the 52 patients, 29 had surgical resection as the only treatment and the remaining 23 had surgical resection with adjunctive preoperative or postoperative radiotherapy. Currently, 39 patients are alive (20 with myasthenia and 19 without), 10 are dead (none dying of myasthenia or tumor), and three patients have been lost to follow-up. The mean follow-up time for all patients was 5.6 years. There were no operative deaths in this series. The 5 year cumulative survival rate for the entire group of 52 patients is 81%; for patients with myasthenia it is 92%; and for those without myasthenia, 71%. This series suggests that the prognosis following resection of thymoma relates primarily to the stage of the tumor and is not significantly influenced by the presence or absence of coexisting myasthenia gravis. The improved survival rate, in contrast to a 1973 report, is a reflection of improved long-term medical management of myasthenia gravis and better postoperative supportive care.
报告了52例胸腺瘤患者的十年手术治疗经验，其中25例伴有重症肌无力，27例不伴有重症肌无力。25例患者为非侵袭性肿瘤（I期），27例为侵袭性肿瘤（II期和III期）。52例患者中，29例仅接受手术切除作为唯一治疗，其余23例接受手术切除并辅以术前或术后放疗。目前，39例患者存活（20例伴有重症肌无力，19例不伴有重症肌无力），10例死亡（均非死于重症肌无力或肿瘤），3例患者失访。所有患者的平均随访时间为5.6年。该系列无手术死亡病例。52例患者的5年累积生存率为81%；伴有重症肌无力的患者为92%；不伴有重症肌无力的患者为71%。该系列表明，胸腺瘤切除后的预后主要与肿瘤分期有关，并存重症肌无力与否对其无显著影响。与1973年的一份报告相比，生存率的提高反映了重症肌无力长期医疗管理的改善以及术后支持治疗的优化。
