胸腺瘤完全切除术后远期预后影响因素分析

Analysis on influencing factors of long-term prognosis after complete resection of thymoma

目的分析胸腺瘤完全切除术后远期预后和影响因素。方法回顾性分析2007年8月至2018年1月金华市中心医院收治的106例胸腺瘤完全切除术患者无复发生存期(recurrent free survival,RFS)和疾病特异生存期(disease specific survival,DSS)的临床资料,并分析患者的相关预后和治疗失败因素。结果所有患者5年、10年RFS分别为86.9%、77.9%;5年、10年DSS分别为95.0%、85.8%。复发与无复发患者的Masaok-Koga分期比较差异有统计学意义(P<0.05);死亡与非死亡患者的性别、世界卫生组织(World Health Organization,WHO)组织学分型、Masaok-Koga分期及肿瘤大小比较差异均有统计学意义(P<0.05)。单因素分析结果显示,Masaoka-Koga分期、WHO组织学分型、肿瘤大小是影响胸腺瘤完全切除术后患者复发的风险因素;Masaoka-Koga分期是影响胸腺瘤特异生存的风险因素。多因素分析结果显示,Masaoka-Koga分期、肿瘤大小、年龄是影响胸腺瘤完全切除术后RFS的独立危险因素;Masaoka-Koga分期是影响胸腺瘤完全切除术后DSS的独立危险因素。结论胸腺瘤完全切除术后患者远期预后良好,10年DSS可达85.8%,Masaoka-Koga分期是其独立预后因素。Masaoka-Koga分期晚、肿块大、年龄小是胸腺瘤复发的危险因素。

Objective To analyze long-term prognosis and influencing factors of thymoma after complete resection.Methods Clinical data of recurrence free survival(RFS)and disease specific survival(DSS)of 106 patients with thymoma after complete resection in Jinhua Central Hospital from August 2007 to January 2018 were retrospectively analyzed.Relevant prognostic and treatment failure factors of patients were analyzed.Results RFS for 5-year and 10-year of 106 cases were 86.9%and 77.9%respectively;DSS for 5-year and 10-year of 106 cases were 95.0%and 85.8%respectively.There was statistically significant difference in Masaok-Koga staging between recurrent and non-recurrent patients(P<0.05).There were statistically significant differences in gender,World Health Organization(WHO)histological classification,Masaok-Koga staging and tumor size between deceased and non-deceased patients(P<0.05).Univariate analysis showed that Masaokak-Koga stage,WHO histological classification and tumor size were risk factors affecting recrudescence in patients with thymoma after complete resection.Masaoka-Koga stage was risk factor affecting specific survival in thymoma.Multivariate analysis showed that Masaoka-Koga stage,tumor size and age were independent risk factors affecting RFS in patients with thymoma after complete resection.Masaoka-Koga stage was independent risk factor affecting DSS in patients with thymoma after complete resection.Conclusion Long-term prognosis of patients with thymoma after complete resection is good,and DSS can reach 85.8%in 10 years.Masaoka-Koga stage is independent prognostic factor for DSS.Advanced Masaoka-Koga stage,larger tumor size and younger age are risk factors for thymoma recurrence.