Application of Postoperative Chemotherapy on Thymomas and Its Prognostic Effect
10.3779/j.issn.1009-3419.2016.07.10
- VernacularTitle:术后化疗胸腺肿瘤中的应用及对其预后的影响
- Author:
MA KE
1
;
GU ZHITAO
;
HAN YONGTAO
;
FU JIANHUA
;
SHEN YI
;
WEI YUCHENG
;
TAN LIJIE
;
ZHANG PENG
;
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. 四川省肿瘤医院胸外科
- Keywords:
Thymic tumors;
Chemotherapy;
Surgery;
Prognosis
- From:
Chinese Journal of Lung Cancer
2016;19(7):473-482
- CountryChina
- Language:Chinese
-
Abstract:
Background and objectiveTo study the role of postoperative chemotherapy and its prognostic effect in Masaoka-Koga stage III and IV thymic tumors.Methods Between 1994 and 2012, 1,700 patients with thymic tumors who underwent surgery without neoajuvant therapy were enrolled for the study. Among them, 665 patients in Masaoka-Koga stage III and IV were further analyzed to evaluate the clinical value of postoperative chemotherapy. TheKaplan-Meier method was used to obtain the survival curve of the patients divided into different subgroups, and theCox regression analysis was used to make multivariate analysis on the factors affecting prognosis. A Propensity-Matched Study was used to evaluate the clinical value of chemotherapy.Results Two-hundred-twenty-one patients were treated with postoperative chemotherapy, while the rest 444 cases were not. The two groups showed signiifcant differences (P<0.05) regarding the incidence of myasthenia gravis, World Health Organization (WHO) histological subtypes, pathological staging, resection status and the use of postopera-tive radiotherapy. WHO type C tumors, incomplete resection, and postoperative radiotherapy were signiifcantly related to increased recurrence and worse survival (P<0.05). Five-year and 10-year disease free survivals (DFS) and recurrence rates in patients who underwent surgery followed by postoperative chemotherapy were 51% and 30%, 46% and 68%, comparing with 73% and 58%, 26% and 40% in patients who had no adjuvant chemotherapy atfer surgery (P=0.001,P=0.001, respectively). In propensity-matched study, 158 pairs of patients with or without postoperative chemotherapy (316 patients in total) were se-lected and compared accordingly. Similar 5-year survival rates were detected between the two groups (P=0.332). Conclusion Pathologically higher grade histology, incomplete resection, and postoperative radiotherapy were found to be associated with worse outcomes in advanced stage thymic tumors. At present, there is no evidence to show that postoperative chemotherapy may help improve prognosis in patients with Masaoka-Koga-Koga stage III and IV thymic tumors.
