Kondo K, Yamakawa Y, Niwa H, Kiriyama M, Fukai I
Second Department of Surgery, School of Medicine Nagoya City University, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Feb;44(2):169-74.
Nineteen cases of thymic carcinoma treated in our hospital (mean age 60.0 years, seven males and twelve females) were studied clinically. Thirteen cases (68.4%) had subjective symptom; for example, chest pain, face edema or cough. Two cases (10.5%) had the associated diseases; one had gammaglobulinemia, the other one had Cushing syndrome and hypogammaglobulinemia. The histological subtypes were eleven squamous cell carcinomas (SCC) (57.9%), three undifferentiated carcinomas, two small cell carcinomas, one papillary adenocarcinoma and one lymphoepithelioma-like carcinoma. The 5 year survival rate of all cases was 42.7%. The 10 years survival rate was 21.4%. The median survival time was 56.1 months. There were one Stage I case, nine stage III cases, four stage IVa cases and five stage IVb cases. More than stage III cases were eighteen (94.7%). Five cases of stage IVb were T2N1M0, T3N1M0, T3N0M1 and T4N0M1. The 5 year survival rate of SCC was 65.6%, and that of the other subtypes was 14.3%. The cases resected completely were only eight cases (42.1%), and the 5 year survival rate of these was 70.0%. On the other hand, the rate of five cases resected incompletely was 53.3%. Metastasis occurred in 12 cases (63.2%). Metastasis occurred frequently in pleura, lymphnode, lung, bone and liver. The radiotherapy for SCC was effective and the 5 year survival rate was 83.3%. Furthermore, there were some long survivors in the cases undergone incomplete resections by postoperative radiotherapy jointly. On the other hand, the chemotherapy was not effective in our series. However, it was reported recently that the regimen including cisplatin was effective. So it was impressed that the combined therapy including surgery radiotherapy and induction chemotherapy would be important to obtain better results.
对我院收治的19例胸腺癌患者（平均年龄60.0岁，男性7例，女性12例）进行了临床研究。13例（68.4%）有主观症状，如胸痛、面部水肿或咳嗽。2例（10.5%）有相关疾病，1例有γ球蛋白血症，另1例有库欣综合征和低γ球蛋白血症。组织学亚型为11例鳞状细胞癌（SCC）（57.9%）、3例未分化癌、2例小细胞癌、1例乳头状腺癌和1例淋巴上皮瘤样癌。所有病例的5年生存率为42.7%，10年生存率为21.4%，中位生存时间为56.1个月。Ⅰ期1例，Ⅲ期9例，Ⅳa期4例，Ⅳb期5例。Ⅲ期以上病例18例（94.7%）。5例Ⅳb期病例分别为T2N1M0、T3N1M0、T3N0M1和T4N0M1。SCC的5年生存率为65.6%，其他亚型为14.3%。完整切除病例仅8例（42.1%），其5年生存率为70.0%。另一方面，5例不完全切除病例的5年生存率为53.3%。12例（63.2%）发生转移，转移常见于胸膜、淋巴结、肺、骨和肝脏。SCC放疗有效，5年生存率为83.3%。此外，术后联合放疗的不完全切除病例中有一些长期存活者。另一方面，在我们的系列研究中化疗无效。然而，最近有报道称含顺铂的方案有效。因此，印象深刻的是，包括手术、放疗和诱导化疗的综合治疗对于获得更好的结果很重要。
