Preoperative Induction Therapy for Locally Advanced Thymic Tumors：A Retrospective Analysis Using the ChART Database
10.3779/j.issn.1009-3419.2016.07.06
- VernacularTitle: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
- Author:
WEI YUCHENG
1
;
GU ZHITAO
;
SHEN YI
;
FU JIANHUA
;
TAN LIEJIE
;
ZHANG PENG
;
HAN YONGTAO
;
CHEN CHUN
;
ZHANG RENQUAN
;
LI YIN
;
CHEN KE-NENG
;
CHEN HEZHONG
;
LIU YONGYU
;
CUI YOUBING
;
WANG YUN
;
PANG LIEWEN
;
YU ZHENTAO
;
ZHOU XINMING
;
LIU YANGCHUN
;
LIU YUAN
;
FANG WENTAO
Author Information
1. 青岛大学医学院附属医院胸外科
- Keywords:
Local progression;
Thymic malignancy;
Induction therapy;
Surgery;
Survival
- From:
Chinese Journal of Lung Cancer
2016;19(7):445-452
- CountryChina
- Language:Chinese
-
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).
