Stage IVb thymic carcinoma: patients with lymph node metastases have better prognoses than those with hematogenous metastases.
Stage IVb thymic carcinoma: patients with lymph node metastases have better prognoses than those with hematogenous metastases.
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IVb期胸腺癌：淋巴结转移患者比血行转移患者预后更好
DOI：
10.1186/s12885-017-3228-2
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发表时间：
2017-03-27
期刊：
影响因子：
3.8
通讯作者：
Wu KL
中科院分区：
文献类型：
--
作者：
Yang Y;Fan XW;Wang HB;Xu Y;Li DD;Wu KL
本研究旨在分析IVb期胸腺癌患者的淋巴转移和血行转移模式，并找出影响其生存的预后因素。1978年9月至2014年10月，68例经病理证实的IVb期胸腺癌患者在复旦大学上海肿瘤中心接受治疗。43例患者有淋巴结转移，无远处转移，其余25例有血行转移。分析临床病理特征，包括年龄、性别、组织学亚型、肿瘤大小、转移、手术切除、放疗和化疗等治疗方法，以及总生存期(OS)和无进展生存期(PFS)等临床结果。中位随访时间为22个月(范围1-126个月)。所有IVb期胸腺癌患者的中位OS为30个月，5年总生存率为25.1%。中位数PFS为11个月，5年PFS为17.9%。有淋巴结转移的IVb期患者的生存率高于远处转移者(40个月对20个月，P=0.002)。重症肌无力患者预后较差(p=0.033)。多变量分析证实转移状态是IVb期胸腺癌患者OS的独立预后因素。有淋巴结转移的患者比有远处转移的患者有更好的生存。对于IVb期胸腺癌患者的预后以及对有淋巴结转移和远处转移的患者探索不同的治疗策略仍有许多工作要做。
This study aimed to analyze the pattern of lymphogenous and hematogenous metastases in patients with stage IVb thymic carcinomas and identify prognostic factors for their survivals. Between September 1978 and October 2014, 68 patients with pathologically confirmed stage IVb thymic carcinomas were treated at Fudan University Shanghai Cancer Center. Forty-three patients had lymph node involvement without distant metastases, and the remaining 25 patients had hematogenous metastases. Clinical-pathological characteristics, including age, sex, histologic subtype, tumor size, metastasis, treatment modalities, such as surgical resection, radiotherapy, and chemotherapy, and clinical outcomes, such as overall survival (OS) and progression free survival (PFS), were analyzed. The median follow-up time was 22 months (range, 1–126 months). The median OS of all patients with stage IVb thymic carcinomas was 30 months, and the 5-year overall survival rate was 25.1%. The median PFS was 11 months, and the 5-year PFS was 17.9%. Stage IVb patients with lymph node involvement had a better survival than those with distant metastasis (40 vs. 20 months, p = 0.002). Patients with myasthenia gravis had a worse prognosis (p = 0.033). Multivariate analysis identified metastatic status as an independent prognostic factor for OS in patients with stage IVb thymic carcinomas. Patients with lymph node involvement had a better survival than those with distant metastases. Much work remains to investigate the prognosis of patients with stage IVb thymic carcinomas and to explore different treatment strategies for patients with lymph node involvement and distant metastases.