CAJ | 학술논문

目的评价以手术治疗为主的综合治疗对胸腺瘤的疗效,探讨胸腺瘤患者预后的影响因素.方法 283例胸腺瘤患者中,275例患者接受手术治疗,其中肿瘤完整性切除术238例,不完整性切除术14例,仅做活检23例;251例患者行放射治疗,其中术前放疗3例,单纯放疗8例,术后放疗235例,放疗+化疗5例;76例患者在治疗的不同时期接受了化疗.Kaplan-Meier方法计算生存率和局部控制率,对可能影响患者预后的因素进行单因素分析和多因素Cox回归分析.结果 283例胸腺瘤患者的中位生存时间为6.0年(0.3～32.0年),5年和10年总生存率分别为80.4%和68.4%.Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期患者的10年总生存率分别为84.3%、75.4%、56.6%和29.6%.45例患者出现复发,出现复发的中位时间为4.0年(0.4-28.0年).70例患者发生远处转移,出现转移的中位时间为2.0年(0.3～30.0年).性别、Masaoka分期、手术方式是患者预后的独立影响因素.结论胸腺瘤患者经过以手术治疗为主的综合治疗,可以获得较好的远期效果,性别、Masaoka分期和手术方式是影响患者预后的因素.
목적 평개이수술치료위주적종합치료대흉선류적료효,탐토흉선류환자예후적영향인소.방법 283례흉선류환자중,275례환자접수수술치료,기중종류완정성절제술238례,불완정성절제술14례,부주활검23례;251례환자행방사치료,기중술전방료3례,단순방료8례,술후방료235례,방료+화료5례;76례환자재치료적불동시기접수료화료.Kaplan-Meier방법계산생존솔화국부공제솔,대가능영향환자예후적인소진행단인소분석화다인소Cox회귀분석.결과 283례흉선류환자적중위생존시간위6.0년(0.3～32.0년),5년화10년총생존솔분별위80.4%화68.4%.Ⅰ기、Ⅱ기、Ⅲ기화Ⅳ기환자적10년총생존솔분별위84.3%、75.4%、56.6%화29.6%.45례환자출현복발,출현복발적중위시간위4.0년(0.4-28.0년).70례환자발생원처전이,출현전이적중위시간위2.0년(0.3～30.0년).성별、Masaoka분기、수술방식시환자예후적독립영향인소.결론 흉선류환자경과이수술치료위주적종합치료,가이획득교호적원기효과,성별、Masaoka분기화수술방식시영향환자예후적인소.
Objective To study the long-term outcome and prognostic factors in patients with thymoma treated with multimodality therapy. Methods 283 patients with pathologically confirmed thymoma were enrolled into this study. Overall survival rate and local control rate were calculated. Cox regression model was used to analyze the prognostic factors. Results The 5-year overall survival rate was 94.3%, 86.3%, 71.6%, 39.4% and 80.4% for patients with stage Ⅰ,Ⅱ,Ⅲ, Ⅳ disease and all patients, respectively. The 10-year overall survival rate was 84.3%, 75.4%, 56.6% , 29.6% and 68.4% for stage Ⅰ,Ⅱ,Ⅲ, Ⅳ disease and all patients. The Masaoka staging, resection extent, and gender were independent prognositic factors in multivariate analysis. Conclusion The Masaoka staging and resection extent are independent prognositic factors in patients with thymoma treated with multimodality therapy.