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IF 2.1 3区医学 Q3 RESPIRATORY SYSTEM

Journal of thoracic disease Pub Date : 2024-11-30 Epub Date: 2024-11-13 DOI:10.21037/jtd-24-1056

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

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引用次数: 0

摘要

背景：胸腺癌是一种罕见的高度恶性肿瘤，起源于胸腺上皮。胸腺癌的治疗和预后仍存在争议。我们回顾性分析了中国单个中心大样本数据库中的生存数据，总结了胸腺癌患者的临床病理特征，并探讨了影响预后的因素：方法：回顾性分析了2010年1月至2023年10月期间接受手术治疗的87例胸腺癌患者的临床资料。其中，74 名患者为胸腺鳞状细胞癌，13 名患者为其他亚型。采用卡普兰-梅耶法计算存活率，单变量分析采用对数秩检验。采用Cox比例危险回归模型进行多变量分析，以评估胸腺癌患者的临床、病理和治疗信息，分析长期生存率，并确定与术后胸腺癌相关的预后因素：5年和10年总生存率（OS）分别为85.6%和69.9%，相应的无病生存率（DFS）分别为76.4%和58.6%。单变量分析显示，胸腺癌患者的Masaoka-Koga分期、切除状态、术后放疗和OS之间存在明显关联。此外，在接受胸腺癌术后治疗的患者中，Masaoka-Koga分期与DFS相关。Cox 多变量分析证实，Masaoka-Koga 分期[危险比（HR）：2.719，95% 置信区间（CI）：1.032-7.163，P=0.043]独立影响手术治疗胸腺癌患者的 DFS，而 Masaoka-Koga 分期（HR：3.690，95% CI：1.043-13.049，P=0.043）和术后放疗（HR：0.319，95% CI：0.102-0.999，P=0.049）成为影响OS的关键预后因素：结论：胸腺鳞状细胞癌是最常见的胸腺癌，完全切除（R0切除）是首选的治疗方式。Masaoka-Koga分期和术后放疗是改善预后的重要指标。

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Long-term survival and prognosis after surgical treatment of patients with thymic carcinoma: a retrospective analysis.

Background: Thymic carcinoma is a type of rare and highly malignant tumor that originates from the thymic epithelium. Treatment and prognosis of thymic carcinoma remain controversial. We retrospectively analyzed survival data from a large sample database in a single center in China to summarize the clinicopathological features of patients with thymic carcinoma and explore the factors affecting prognosis.

Methods: The clinical data of 87 patients with thymic carcinoma who underwent surgical treatment between January 2010 and October 2023 were retrospectively analyzed. Of these, 74 patients had thymic squamous cell carcinoma, and 13 had other subtypes. The Kaplan-Meier method was used to calculate survival rate, and the log-rank test was employed for univariate analysis. The Cox proportional hazards regression model was used for multivariate analysis to evaluate the clinical, pathological, and therapeutic information of patients with thymic carcinoma, analyze long-term survival, and identify prognostic factors associated with postoperative thymic carcinoma.

Results: The 5- and 10-year overall survival (OS) rates were 85.6% and 69.9%, respectively, and the corresponding disease-free survival (DFS) rates were 76.4% and 58.6%, respectively. Univariate analysis revealed significant associations between the Masaoka-Koga stage, resection status, postoperative radiotherapy, and OS in patients with thymic carcinoma. Furthermore, the Masaoka-Koga stage is correlated with DFS in patients who underwent postoperative treatment for thymic carcinoma. Cox multivariate analysis confirmed that the Masaoka-Koga stage [hazard ratio (HR): 2.719, 95% confidence interval (CI): 1.032-7.163, P=0.043] independently influenced DFS in surgically treated patients with thymic carcinoma, whereas the Masaoka-Koga stage (HR: 3.690, 95% CI: 1.043-13.049, P=0.043) and postoperative radiotherapy (HR: 0.319, 95% CI: 0.102-0.999, P=0.049) emerged as critical prognostic factors affecting OS.

Conclusions: Thymic squamous cell carcinoma is the most prevalent form of thymic carcinoma, and complete resection (R0 resection) is the preferred treatment modality. The Masaoka-Koga stage and postoperative radiotherapy are significant prognostic indicators for improved outcomes.

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来源期刊

Journal of thoracic disease RESPIRATORY SYSTEM-

CiteScore

4.60

自引率

4.00%

发文量

254

期刊介绍： The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.