Postoperative Survival for Patients with Thymoma Complicating Myasthenia Gravis- Preliminary Retrospective Results of the ChART Database
10.3779/j.issn.1009-3419.2016.07.03
- VernacularTitle:合并重症肌无力的胸腺瘤患者术后生存的初步分析--ChART数据库回顾性结果
- Author:
WANG FANGRUI
1
;
PANG LIEWEN
;
FU JIANHUA
;
SHEN YI
;
WEI YUCHENG
;
TAN LIJIE
;
ZHANG PENG
;
HAN YONGTAO
;
CHEN CHUN
;
ZHANG RENQUAN
;
LI YIN
;
CHEN KE-NENG
;
CHEN HEZHONG
;
LIU YONGYU
;
CUI YOUBING
;
WANG YUN
;
YU ZHENTAO
;
ZHOU XINMING
;
LIU YANGCHUN
;
LIU YUAN
;
GU ZHITAO
;
FANG WENTAO
Author Information
1. 复旦大学附属华山医院胸外科
- Keywords:
Thymoma;
Myasthenia gravis (MG);
Survival
- From:
Chinese Journal of Lung Cancer
2016;19(7):418-424
- CountryChina
- Language:Chinese
-
Abstract:
Background and objectiveIt is so far not clear that how myasthenia gravis (MG) affected the prognosis of thymoma patients. The aim of this assay is to compare the postoperative survival between patients with thymoma only and those with both thymoma and MG.MethodsThe Chinese Alliance for Research in Thymomas (ChART) registry recruited patients with thymoma from 18 centers over the country on an intention to treat basis from 1992 to 2012. Two groups were formed according to whether the patient complicated MG. Demographic and clinical data were reviewed, Patients were fol-lowed and their survival status were analyzed.Results There were 1,850 patients included in this study, including 421 with and 1,429 without MG. Complete thymectomy were done in 91.2% patients in MG group and 71.0% in non-MG group (P<0.05). There were more percentage of patients with the histology of thymoma AB, B1, or B2 (P<0.05) in MG group, and more percentage of patients with MG were in Masaoka stage I and II. The 5 year and 10 year OS rates were both higher in MG group (93%vs 88%; 83%vs 81%,P=0.034) respectively. The survival rate was signiifcantly higher in patients with MG when the Masaoka staging was III/IV (P=0.003). Among patients with advanced stage thymoma (stage III, IVa, IVb), the constitu-ent ratios of III, IVa, IVb were similar between MG and Non-MG group. Histologically, however, there were signiifcantly more proportion of AB/B1/B2/B3 in the MG group while there were more C in the non-MG group (P=0.000). Univariate analyses for all patients showed that MG, WHO classiifcation, Masaoka stage, surgical approach, chemotherapy and radiotherapy and resectability were signiifcant factors, and multivariate analysis showed WHO Classiifcation, Masaoka stage, and resectability were strong independent prognostic indicators.ConclusionAlthough MG is not an independent prognostic factor, the sur-vival of patients with thymoma was superior when MG was present, especially in late Masaoka stage patients. Possible reasons included early diagnosis of the tumor, better histologic types, an overall higher R0 resection and less recurrence.
