Surgical treatment and prognostic analysis of thymoma

doi:10.3877/cma.j.issn.2095-8773.2018.02.08

Abstract

Abstract:

Objective

To explore the prognostic factors affecting the long-term survival of patients with thymoma.

Methods

The clinical data of 55 patients with thymoma who were treated with thoracic surgery in Gansu Provincial People's Hospital from January 2004 to January 2017 were retrospectively analyzed. The possible prognostic factors were analyzed by univariate analysis and multivariate analysis with Kaplan-Meier method and Cox proportional hazard model, respectively.

Results

Two cases were lost and 53 cases were followed up successfully. All 53 patients underwent surgery. All patients were followed up for 1 to 125 months, and the 1, 3, 5, 10 year survival rates were 71.1%, 56.7%, 39.3% and 23.3% respectively. The significant prognostic factors demonstrated by univariate analysis included age, clinical symptoms, tumor diameter, Masaoka staging, WHO histologic classification, completeness of resection, and chemoradiotherapy (P<0.01). According to multivariate analysis, the tumor type (HR=5.15, 95% CI: 1.573-16.883, P<0.05), tumor diameter (HR=5.53, 95% CI: 1.879-11.797, P<0.05), WHO classification (HR=13.23, 95% CI: 3.015-29.230, P<0.05), Masaoka staging (HR=5.18, 95% CI: 1.597-13.737, P<0.05) and chemoradiotherapy (HR=12.14, 95% CI: 2.979-49.503, P<0.05) are independent factors affecting the postoperative survival rate of thymoma.

Conclusions

Tumor diameter, tumor resection, WHO classification, Masaoka and postoperative chemoradiotherapy were independent prognostic factors.

Key words: Thymoma, Tumor diameter, Tumor resection, WHO classification, Masaoka staging, Radiotherapy, Chemotherapy

Xiaolei Zhu, Zijiang Zhu, Yao Pang, Wenhao Wang, Guangxin Tuo. Surgical treatment and prognostic analysis of thymoma[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2018, 05(02): 107-112.

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Figures/Tables 3

References 22

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性别		1年生存率(%)	3年生存率(%)	5年生存率(%)	10年生存率(%)	χ²值	P值
性别		?	?	?	?	0.02	0.991
?	男性(n＝33)	96.8	87.8	75.8	45.8	?	?
?	女性(n＝20)	97.6	85.7	76.2	47.6	?	?
年龄		?	?	?	?	5.04	0.543
?	<30岁(n＝7)	85.7	71.4	61.4	42.9	?	?
?	30～60岁(n＝36)	97.2	88.9	67.7	44.4	?	?
?	>60岁(n＝10)	89.0	79.9	70.0	40.0	?	?
有无症状		?	?	?	?	13.23	0.004
?	有(n＝33)	96.9	78.7	42.4	18.1	?	?
?	无(n＝20)	100.0	95.0	90.0	78.0	?	?
肿瘤直径		?	?	?	?	7.748	0.021
?	<5 cm(n＝13)	92.3	92.3	76.9	4.1	?	?
?	5～10 cm(n＝27)	96.2	85.1	74.0	40.7	?	?
?	>10 cm	92.3	76.9	15.3	7.6	?	?
肿瘤切除范围		?	?	?	?	15.75	0.015
?	R0(n＝23)	100.0	95.6	91.3	78.2	?	?
?	R1(n＝16)	87.5	75.0	43.7	7.1	?	?
?	R2(n＝14)	71.4	50	28.5	7.1	?	?
WHO分型		?	?	?	?	25.69	0.041
?	A型(n＝11)	100.0	100.0	90.1	72.7	?	?
?	AB型(n＝13)	100.0	92.3	76.9	61.5	?	?
?	B1型(n＝6)	100.0	83.3	50.0	16.6	?	?
?	B2型(n＝9)	100.0	88.8	55.5	11，.1	?	?
?	B3型(n＝5)	80.0	75.0	40.0	0.00	?	?
?	C型(n＝9)	78.5	55.5	22.2	0.00	?	?
Masaoka分期		?	?	?	?	16.18	<0.001
?	Ⅰ期(n＝9)	100.0	100.0	88.9	66.7	?	?
?	Ⅱ期(n＝20)	95.0	95.0	85.0	55.0	?	?
?	Ⅲ期(n＝16)	93.7	87.5	43.7	6.2	?	?
?	Ⅳ期(n＝8)	75.0	25.0	0.00	0.00	?	?
术后放化疗		?	?	?	?	31.81	0.001
?	是(n＝30)	93.3	78.5	40.0	20.0	?	?
?	否(n＝23)	95.6	91.3	82.6	47.8	?	?

性别		1年生存率(%)	3年生存率(%)	5年生存率(%)	10年生存率(%)	χ²值	P值
性别		?	?	?	?	0.02	0.991
?	男性(n＝33)	96.8	87.8	75.8	45.8	?	?
?	女性(n＝20)	97.6	85.7	76.2	47.6	?	?
年龄		?	?	?	?	5.04	0.543
?	<30岁(n＝7)	85.7	71.4	61.4	42.9	?	?
?	30～60岁(n＝36)	97.2	88.9	67.7	44.4	?	?
?	>60岁(n＝10)	89.0	79.9	70.0	40.0	?	?
有无症状		?	?	?	?	13.23	0.004
?	有(n＝33)	96.9	78.7	42.4	18.1	?	?
?	无(n＝20)	100.0	95.0	90.0	78.0	?	?
肿瘤直径		?	?	?	?	7.748	0.021
?	<5 cm(n＝13)	92.3	92.3	76.9	4.1	?	?
?	5～10 cm(n＝27)	96.2	85.1	74.0	40.7	?	?
?	>10 cm	92.3	76.9	15.3	7.6	?	?
肿瘤切除范围		?	?	?	?	15.75	0.015
?	R0(n＝23)	100.0	95.6	91.3	78.2	?	?
?	R1(n＝16)	87.5	75.0	43.7	7.1	?	?
?	R2(n＝14)	71.4	50	28.5	7.1	?	?
WHO分型		?	?	?	?	25.69	0.041
?	A型(n＝11)	100.0	100.0	90.1	72.7	?	?
?	AB型(n＝13)	100.0	92.3	76.9	61.5	?	?
?	B1型(n＝6)	100.0	83.3	50.0	16.6	?	?
?	B2型(n＝9)	100.0	88.8	55.5	11，.1	?	?
?	B3型(n＝5)	80.0	75.0	40.0	0.00	?	?
?	C型(n＝9)	78.5	55.5	22.2	0.00	?	?
Masaoka分期		?	?	?	?	16.18	<0.001
?	Ⅰ期(n＝9)	100.0	100.0	88.9	66.7	?	?
?	Ⅱ期(n＝20)	95.0	95.0	85.0	55.0	?	?
?	Ⅲ期(n＝16)	93.7	87.5	43.7	6.2	?	?
?	Ⅳ期(n＝8)	75.0	25.0	0.00	0.00	?	?
术后放化疗		?	?	?	?	31.81	0.001
?	是(n＝30)	93.3	78.5	40.0	20.0	?	?
?	否(n＝23)	95.6	91.3	82.6	47.8	?	?

因素	β值	Wald值	HR	95%CI	P值
切除方式	1.639	7.260	5.153	(1.57～16.88)	0.007
有无症状	1.361	3.123	1.263	(0.71～3.51)	0.254
肿瘤直径	1.793	8.603	5.532	(1.87～11.79)	0.003
WHO组织学分类	2.975	14.253	13.234	(3.01～29.23)	<0.001
Masaoka分期	1.645	10.852	5.185	(1.95～13.73)	<0.001
放化疗	2.496	12.005	12.144	(2.97～49.50)	0.005

因素	β值	Wald值	HR	95%CI	P值
切除方式	1.639	7.260	5.153	(1.57～16.88)	0.007
有无症状	1.361	3.123	1.263	(0.71～3.51)	0.254
肿瘤直径	1.793	8.603	5.532	(1.87～11.79)	0.003
WHO组织学分类	2.975	14.253	13.234	(3.01～29.23)	<0.001
Masaoka分期	1.645	10.852	5.185	(1.95～13.73)	<0.001
放化疗	2.496	12.005	12.144	(2.97～49.50)	0.005

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