中国肺癌杂志2016，Vol.19Issue(7)：445-452,8.DOI:10.3779/j.issn.1009-3419.2016.07.06
ChART回顾性数据库局部进展期胸腺瘤的术前诱导治疗效果分析
Preoperative Induction Therapy for Locally Advanced Thymic Tumors：A Retrospective Analysis Using the ChART Database
魏煜程 1李印 2陈克能 3陈和忠 4刘永煜 5崔有斌 6王允 7庞烈文 8于振涛 9周鑫明 10柳阳春 11谷志涛 12刘媛 12方文涛 12沈毅 1傅剑华 13谭黎杰 14张鹏 15韩泳涛 16陈椿 17张仁泉18
作者信息
- 1. 266001青岛，青岛大学医学院附属医院胸外科
- 2. 450008郑州，郑州大学附属肿瘤医院胸外科
- 3. 100142北京，北京大学附肿瘤医院胸外科
- 4. 200433上海，长海医院胸心外科
- 5. 110042沈阳，辽宁肿瘤医院胸外科
- 6. 130021长春，吉林大学附属第一医院胸外科
- 7. 610041成都，四川大学华西医院胸外科
- 8. 200032上海，复旦大学附属华山医院胸外科
- 9. 300060天津，天津医科大学附属肿瘤医院食管癌中心
- 10. 310022杭州，浙江省肿瘤医院胸外科
- 11. 330006南昌，江西省人民医院胸外科
- 12. 200030上海，上海交通大学附属上海胸科医院
- 13. 510060广州，中山大学附属肿瘤医院胸外科
- 14. 200032上海，复旦大学附属中山医院胸外科
- 15. 300052天津，天津医科大学附属总医院胸外科
- 16. 610041成都，四川省肿瘤医院胸外科
- 17. 350001福州，福建医科大学附属协和医院胸外科
- 18. 230022合肥，安徽医科大学附属第一医院胸外科
- 折叠
摘要
Abstract
Background and objectiveTo evaluate the role of preoperative induction therapy on prognosis of local-ly advanced thymic malignancies.MethodsBetween 1994 and 2012, patients received preoperative induction therapies (IT group) in the Chinese Alliance for Research in Thymomas (ChART) database, were compared with those having surgery di-rectly atfer preoperative evaluation (DS group). All tumors receiving induction therapies were locally advanced (clinically stage III-IV) before treatment and those turned out to be in pathological stage I and II were considered downstaged by induction. Clinical pathological characteristics were retrospectively analyzed. To more accurately study the effect of induction therapies, stage IV patients were then excluded. Only stage I-III tumors in the IT group and stage III cases in the DS group were selected for further comparison in a subgroup analysis.Results Only 68 (4%) out of 1,713 patients had induction therapies, with a R0 resection of 67.6%, 5-year recurrence of 44.9%, and 5- and 10-year overall survivals (OS) of 49.7% and 19.9%. Seventeen pa-tients (25%) were downstaged atfer induction. Signiifcantly more thymomas were downstaged than thymic carcinomas (38.7%vs 13.9%,P=0.02). Tumors downstaged atfer induction had signiifcantly higher 5-year OS than those not downstaged (93.8%vs 35.6%,P=0.013). For the subgroup analysis when stage IV patients were excluded, 5-year OS was 85.2% in the DS group and 68.1% in the IT group (P<0.001), although R0 resection were similar (76.4%vs 73.3%,P=0.63). However, 5-year OS in tumors downstaged atfer induction (93.8%) was similar to those in the DS group (85.2%,P=0.438), both signiifcantly higher than those not downstaged atfer induction (35.6%,P<0.001).ConclusionOnly 68 (4%) out of 1,713 patients had induction therapies, with a R0 resection of 67.6%, 5-year recurrence of 44.9%, and 5- and 10-year overall survivals (OS) of 49.7% and 19.9%. Seventeen patients (25%) were downstaged atfer induction. Signiifcantly more thymomas were downstaged than thy-mic carcinomas (38.7%vs 13.9%,P=0.02). Tumors downstaged atfer induction had signiifcantly higher 5-year OS than those not downstaged (93.8%vs 35.6%,P=0.013). For the subgroup analysis when stage IV patients were excluded, 5-year OS was 85.2% in the DS group and 68.1% in the IT group (P<0.001), although R0 resection were similar (76.4%vs 73.3%,P=0.63). However, 5-year OS in tumors downstaged atfer induction (93.8%) was similar to those in the DS group (85.2%,P=0.438), both signiifcantly higher than those not downstaged atfer induction (35.6%,P<0.001).关键词
局部进展/胸腺瘤/诱导治疗/手术/生存率Key words
Local progression/Thymic malignancy/Induction therapy/Surgery/Survival引用本文复制引用
魏煜程,李印,陈克能,陈和忠,刘永煜,崔有斌,王允,庞烈文,于振涛,周鑫明,柳阳春,谷志涛,刘媛,方文涛,沈毅,傅剑华,谭黎杰,张鹏,韩泳涛,陈椿,张仁泉..ChART回顾性数据库局部进展期胸腺瘤的术前诱导治疗效果分析[J].中国肺癌杂志,2016,19(7):445-452,8.
