胸腺瘤切除术后预后因素研究

Analysis of Prognostic Factors for Thymoma Patients After Thymectomy

目的分析影响胸腺瘤患者手术切除术后生存率的因素。方法回顾性分析2011年1月~2018年12月201例胸腺瘤手术资料,男106例,女95例,年龄(52.5±14.0)岁。合并重症肌无力133例。并对患者进行随访,获得生存预后的随访数据。使用Cox比例风险模型分析影响胸腺瘤术后生存的预后因素。结果全组5年总生存率90.2%,5年无复发生存率86.9%。单因素分析显示,肿瘤直径越大、非R0切除、TNM分期Ⅲ+Ⅳ期与总生存及无复发生存相关,多因素Cox回归分析显示,仅TNM分期Ⅲ+Ⅳ期是胸腺瘤5年总生存(HR=5.956,95%CI:1.656~21.419,P=0.006)和无复发生存(HR=10.381,95%CI:3.150~34.212,P=0.000)的独立预后因素。结论胸腺瘤患者手术治疗远期预后较好,5年生存率可达90.2%。TNM分期是胸腺瘤术后5年生存及无复发生存的独立预后因素。

Objective To analyze factors influencing the prognosis of thymoma patients after thymectomy.Methods A total of 201 patients with thymoma,including 106 males and 95 females,who underwent thymectomy from January 2011 to December 2018 in this hospital were retrospectively reviewed.Their average age was(52.5±14.0)years old.There were 133 patients complicating with myasthenia gravis(MG).The patients were followed up to get the data of survival and prognosis.The Cox regression analysis was performed to analyze prognostic factors of survival.Results The 5-year overall survival(OS)rate of all the patients was 90.2%,and the 5-year recurrence-free survival(RFS)rate was 86.9%.Univariable analysis demonstrated that large diameter,non-R0 resection,and TNM stageⅢandⅣwere related with the OS and RFS.Multivariable Cox regression analysis demonstrated that TNM stageⅢandⅣwas the independent risk factor for OS(HR=5.956,95%CI:1.656-21.419,P=0.006)and RFS(HR=10.381,95%CI:3.150-34.212,P=0.000).Conclusions The long-term prognosis of patients with thymoma is good,and the 5-year survival rate can reach 90.2%.The TNM staging is an independent prognostic factor for 5-year OS and RFS.