中国肺癌杂志2016，Vol.19Issue(7)：453-458,6.DOI:10.3779/j.issn.1009-3419.2016.07.07
胸腔镜与开放手术治疗临床早期胸腺恶性肿瘤的围手术期效果及长期生存率的比较
Perioperative Outcomes and Long-term Survival in Clinically Early-stage Thymic Malignancies：Video-assisted Thoracoscopic Thymectomy versus Open Approaches
汪灏 1陈椿 2张仁泉 3李印 4陈克能 5陈和忠 6刘永煜 7崔有斌 8王允 9庞烈文 10于振涛 11谷志涛 12周鑫明 13柳阳春 14刘媛 12方文涛 12丁建勇 1谭黎杰 1傅剑华 15沈毅 16魏煜程 16张鹏 17韩泳涛18
作者信息
- 1. 200032上海，复旦大学附属中山医院胸外科
- 2. 350001福州，福建医科大学附属协和医院胸外科
- 3. 230022合肥，安徽医科大学附属第一医院胸外科
- 4. 450008郑州，郑州大学附属肿瘤医院胸外科
- 5. 100142北京，北京大学附肿瘤医院胸外科
- 6. 200433上海，长海医院胸心外科
- 7. 110042沈阳，辽宁肿瘤医院胸外科
- 8. 130021长春，吉林大学附属第一医院胸外科
- 9. 610041成都，四川大学华西医院胸外科
- 10. 200032上海，复旦大学附属华山医院胸外科
- 11. 300060天津，天津医科大学附属肿瘤医院食管癌中心
- 12. 200030上海，上海交通大学附属上海胸科医院
- 13. 310022杭州，浙江省肿瘤医院胸外科
- 14. 330006南昌，江西省人民医院胸外科
- 15. 510060广州，中山大学附属肿瘤医院胸外科
- 16. 266001青岛大学医学院附属医院胸外科
- 17. 300052天津，天津医科大学附属总医院胸外科
- 18. 610041成都，四川省肿瘤医院胸外科，马可
- 折叠
摘要
Abstract
Background and objectiveVideo-assisted thoracoscopic surgery (VATS) theoretically offers advantages over open thymectomy for clinically early-stage (Masaoka-Koga stage I and II) thymic malignancies. However, longterm outcomes have not been well studied. We compared the postoperative outcomes and survival from a cohort study based on the database of the Chinese Alliance for Research in Thymomas (ChART).MethodsBetween 1994 and 2012, data of 1,117 patients hav-ing surgery for clinically early-stage (Masaoka-Koga stage I and II) tumors were enrolled for the study. Among them, 241 cases underwent VATS thymectomy (VATS group), while 876 cases underwent open thymectomy (Open group). Univariate analyses were used to compare the clinical character and perioperative outcomes between the two groups. And multivariate analysis was performed to determine the independent predictive factors for long-term survival.Results Compared with the Open group, the VATS group had higher percentage of total thymectomy (80.5%vs 73.9%,P=0.028), resection rate (98.8%vs 88.7%,P<0.001) and less recurrence (2.9%vs 16.0%,P<0.001). Five-year overall survival was 92% atfer VATS and 92% atfer open thymectomy, with no signiifcant difference between the two groups (P=0.15). However, 5-year disease free survival were 92% in VATS group and 83% in Open group (P=0.011).Cox proportional hazards model revealed that WHO classiifcation, Masaoka-Koga stage and adjuvant therapy were independent predictive factors for overall survival, while surgical approach had no signiifcant impact on long-term outcome.ConclusionhTis study suggests that VATS thymectomy is an effective approach for clinically early-stage thymic malig-nancies. And it may offer better perioperative outcomes, as well as equal oncological survival.关键词
胸腺恶性肿瘤/胸腺切除术/胸腔外科/开胸手术Key words
Thymic malignancies/hTymectomy/Video-assisted hToracoscopic Surgery (VATS)/Open surgery引用本文复制引用
汪灏,陈椿,张仁泉,李印,陈克能,陈和忠,刘永煜,崔有斌,王允,庞烈文,于振涛,谷志涛,周鑫明,柳阳春,刘媛,方文涛,丁建勇,谭黎杰,傅剑华,沈毅,魏煜程,张鹏,韩泳涛..胸腔镜与开放手术治疗临床早期胸腺恶性肿瘤的围手术期效果及长期生存率的比较[J].中国肺癌杂志,2016,19(7):453-458,6.
