胸腺瘤外科手术治疗及预后的回顾性分析

Surgical treatment and prognosis factors of thymoma:a retrospective analysis

目的:研究外科手术治疗胸腺瘤预后的影响因素。方法:回顾分析2010~2018年收治的152例胸腺瘤患者的临床资料,评估患者年龄、性别、肿瘤直径、重症肌无力、手术方式、手术时间、术中出血量、术后引流量、住院时间、Masaoka分期、TNM分期、WHO病理分型对预后的影响。结果:患者25~76岁,平均(51.91±14.87)岁,肿瘤直径平均(6.86±2.36)cm,术中出血量平均(155.72±118.84)mL,手术时间平均(132.96±45.26)min。单因素生存分析显示,重症肌无力状态(P=0.015)、手术方式(P<0.001)、Masaoka分期(P<0.001)、TNM分期(P<0.001)、WHO病理分型(P<0.001)对预后有影响。多因素生存分析显示,手术方式(P=0.006)、Masaoka分期(P=0.042)、WHO病理分型(P=0.002)是影响胸腺瘤患者无病生存期的独立因素。结论:胸腺瘤的早期诊断与治疗利于提高患者无病生存期,手术方式、Masaoka分期、WHO病理分型利于评估患者预后状况。

Objective:To assess the prognostic factors of thymoma treated by surgery.Methods:Clinical data of 152 patients who were admitted from 2010 to 2018 were retrospectively analyzed.The influence of age,gender,tumor diameter,myasthenia gravis,o peration method,operation time,intraoperative blood loss,postoperative drainage,hospitalization time,Masaoka stage,tumor node m etastasis(TNM)stage,and the world health organization(WHO)pathological classification on prognosis were analyzed.Results:The age ranged from 25 to 76 years,with an average of(51.91±14.87)years old,the average tumor diameter was(6.86±2.36)cm,the a verage intraoperative blood loss was(155.72±118.84)mL,the mean operation time was(132.96±45.26)min.Univariate survival a nalysis showed that there were significant differences in myasthenia gravis status(P=0.015),surgical method(P<0.001),Masaoka stage(P<0.001),TNM stage(P<0.001)and WHO pathological classification(P<0.001).Multivariate survival analysis showed that surgical method(P=0.006),Masaoka stage(P=0.042)and WHO pathological classification(P=0.002)were independent p rognostic factors affecting disease-free survival of patients with thymoma.Conclusions:Early diagnosis and treatment of thymoma are beneficial to improve the disease free survival.The surgical method,Masaoka stage,WHO pathological classification are beneficial to e valuate the prognosis of patients.