晚期胸腺癌外科治疗模式的临床研究  

Surgical Treatment of Advanced Stage Thymic Carcinomas

作　　者：汪大伟 石殿鹏 李鉴[2] WANG Da-wei;SHI Dian-peng;LI Jian(Department of Thoracic Surgery,China Meitan General Hospital,Beijing 100028,China;Department of Thoracic Surgery,Cancer Hospital,Chinese Academy of Medical Sciences,Beijing 100021,China)

机构地区：[1]煤炭总医院胸外科,北京100028 [2]中国医学科学院肿瘤医院胸外科,北京100021

出　　处：《中国现代手术学杂志》2018年第5期376-379,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨晚期胸腺癌外科治疗模式与预后的关系。方法回顾性分析进行手术且病理确诊的71例晚期胸腺癌患者的临床资料,按Masaoka分期标准:Ⅲ期55例,ⅣA期16例。均行手术治疗,其中根治性切除29例,姑息性切除25例,探查活检17例。单纯手术治疗10例,术后行放疗30例,化疗2例,放化疗29例。采用Kaplan-Meier法进行生存分析,并进行单因素和多因素分析影响预后的因素。结果单因素分析显示,切除范围、术后放疗与术后放疗+化疗均为晚期胸腺癌患者预后的影响因素(P <0. 05),术后辅助化疗未显示其与预后的相关性(P> 0. 05)。多因素COX回归分析显示,切除范围和术后辅助放疗是影响预后的独立因素。结论晚期胸腺癌患者生存期短,治疗应以手术切除为主,同时辅以放疗为一体的综合治疗。Objective To investigate the relationship between surgical treatment and prognosis of advanced thymic carcinoma. Methods A total of 71 cases with advanced thymic carcinoma underwent surgical intervention and diagnosed by pathological exam were analyzed retrospectively.According to Masaoka staging criteria,55 patients were in stageⅢand 16 patients were in stageⅣA.All patients performed surgical treatment,including radical resection in 29 cases,palliative resection in 25 cases and exploration biopsy in 17 cases.Except 10 cases treated by surgery alone,radiotherapy was carried out in 30 cases,chemotherapy in 2 cases and radiotherapy combined with chemotherapy in 29 cases.Survival was analyzed by Kaplan-Meier method,and univariate and multivariate analysis was performed to determine the prognostic factors. Results Univariate analysis showed that resection extent,postoperative radiotherapy and postoperative radiotherapy plus chemotherapy were the influential factors for the prognosis of advanced thymic carcinoma(P<0.05),but postoperative adjuvant chemotherapy showed no correlation with the prognosis(P>0.05).Multivariate COX regression analysis showed that the extent of resection and postoperative adjuvant radiotherapy were the independent prognostic factors for advanced thymic carcinoma. Conclusions The prognosis of the patients with advanced thymic carcinoma tumors is poor.Surgical resection combined with radiotherapy should be the reasonable and effect treatment.

关 键 词：胸腺肿瘤 肿瘤分期 预后 因素分析 统计学 

分 类 号：R736.3[医药卫生—肿瘤]