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
背景与目的探讨术前诱导治疗在胸腺瘤中的应用及其对局部进展期胸腺瘤预后的影响。方法收集中国胸腺肿瘤协作组（Chinese Alliance of Research for hTymomas, ChART）1994年1月1日至2012年12月31日回顾性数据库中局部进展期胸腺瘤（Masaoka-Koga分期为III期-IVa期）病例。分为诱导治疗组和直接手术组，对比分析两组的R0切除率、5年复发率及5年生存率等指标。诱导治疗组术后分期为Masaoka-Koga I期-II期的病例视为诱导治疗后降期。为更加精确评估诱导治疗效果，在剔除术后IV期病例的基础上，再次将诱导治疗组术后Masaoka-Kog...
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| Published in | 中国肺癌杂志 Vol. 19; no. 7; pp. 445 - 452 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
青岛大学医学院附属医院胸外科,青岛,266001%上海交通大学附属上海胸科医院,上海,200030%中山大学附属肿瘤医院胸外科,广州,510060%复旦大学附属中山医院胸外科,上海,200032%天津医科大学附属总医院胸外科,天津,300052%四川省肿瘤医院胸外科,成都,610041%福建医科大学附属协和医院胸外科,福州,350001%安徽医科大学附属第一医院胸外科,合肥,230022%郑州大学附属肿瘤医院胸外科,郑州,450008%北京大学附肿瘤医院胸外科,北京,100142%长海医院胸心外科,上海,200433%辽宁肿瘤医院胸外科,沈阳,110042%吉林大学附属第一医院胸外科,长春,130021%四川大学华西医院胸外科,成都,610041%复旦大学附属华山医院胸外科,上海,200032%天津医科大学附属肿瘤医院食管癌中心,天津,300060%浙江省肿瘤医院胸外科,杭州,310022%江西省人民医院胸外科,南昌,330006
2016
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1009-3419 1999-6187 |
| DOI | 10.3779/j.issn.1009-3419.2016.07.06 |
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| Abstract | 背景与目的探讨术前诱导治疗在胸腺瘤中的应用及其对局部进展期胸腺瘤预后的影响。方法收集中国胸腺肿瘤协作组（Chinese Alliance of Research for hTymomas, ChART）1994年1月1日至2012年12月31日回顾性数据库中局部进展期胸腺瘤（Masaoka-Koga分期为III期-IVa期）病例。分为诱导治疗组和直接手术组，对比分析两组的R0切除率、5年复发率及5年生存率等指标。诱导治疗组术后分期为Masaoka-Koga I期-II期的病例视为诱导治疗后降期。为更加精确评估诱导治疗效果，在剔除术后IV期病例的基础上，再次将诱导治疗组术后Masaoka-Koga I期-III期的病例与直接手术组Masaoka-Koga III期的病例进行对比分析。结果ChART回顾性数据库1,713例有效病例中，局部进展期胸腺瘤706例，仅68例（4%）作了术前诱导治疗，R0切除率为67.6%，5年复发率为44.9%，5年与10年生存率分别为49.7%和19.9%。其中17例诱导治疗后达到降期，降期亚组中胸腺瘤的比例高于胸腺癌（38.7%vs 13.9%,P=0.02）；与未降期亚组相比，降期亚组获得更高的5年生存率（93.8%vs 35.6%,P=0.013）。剔除术后IV期的病例后，直接手术组和诱导治疗组R0切除率接近（76.4%vs 73.3%,P=0.63），但5年生存率差异明显（85.2%vs 68.1%,P＜0.001），对于降期亚组，5年生存率优于直接手术组（93.8%vs 85.2%, P=0.438），未降期亚组5年生存率仅35.6%，明显差于降期亚组和直接手术组（P＜0.001）。结论术前诱导治疗目前尚未在局部进展期胸腺瘤中广泛应用，但ChART的回顾性数据研究显示通过有效的术前诱导治疗可以使难以彻底切除的病例降期后增加R0切除的机会，从而延长生存，特别是胸腺瘤的病例。这一初步结果将有助于未来的研究。 |
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| AbstractList | 背景与目的探讨术前诱导治疗在胸腺瘤中的应用及其对局部进展期胸腺瘤预后的影响。方法收集中国胸腺肿瘤协作组（Chinese Alliance of Research for hTymomas, ChART）1994年1月1日至2012年12月31日回顾性数据库中局部进展期胸腺瘤（Masaoka-Koga分期为III期-IVa期）病例。分为诱导治疗组和直接手术组，对比分析两组的R0切除率、5年复发率及5年生存率等指标。诱导治疗组术后分期为Masaoka-Koga I期-II期的病例视为诱导治疗后降期。为更加精确评估诱导治疗效果，在剔除术后IV期病例的基础上，再次将诱导治疗组术后Masaoka-Koga I期-III期的病例与直接手术组Masaoka-Koga III期的病例进行对比分析。结果ChART回顾性数据库1,713例有效病例中，局部进展期胸腺瘤706例，仅68例（4%）作了术前诱导治疗，R0切除率为67.6%，5年复发率为44.9%，5年与10年生存率分别为49.7%和19.9%。其中17例诱导治疗后达到降期，降期亚组中胸腺瘤的比例高于胸腺癌（38.7%vs 13.9%,P=0.02）；与未降期亚组相比，降期亚组获得更高的5年生存率（93.8%vs 35.6%,P=0.013）。剔除术后IV期的病例后，直接手术组和诱导治疗组R0切除率接近（76.4%vs 73.3%,P=0.63），但5年生存率差异明显（85.2%vs 68.1%,P<0.001），对于降期亚组，5年生存率优于直接手术组（93.8%vs 85.2%, P=0.438），未降期亚组5年生存率仅35.6%，明显差于降期亚组和直接手术组（P<0.001）。结论术前诱导治疗目前尚未在局部进展期胸腺瘤中广泛应用，但ChART的回顾性数据研究显示通过有效的术前诱导治疗可以使难以彻底切除的病例降期后增加R0切除的机会，从而延长生存，特别是胸腺瘤的病例。这一初步结果将有助于未来的研究。 背景与目的探讨术前诱导治疗在胸腺瘤中的应用及其对局部进展期胸腺瘤预后的影响。方法收集中国胸腺肿瘤协作组（Chinese Alliance of Research for hTymomas, ChART）1994年1月1日至2012年12月31日回顾性数据库中局部进展期胸腺瘤（Masaoka-Koga分期为III期-IVa期）病例。分为诱导治疗组和直接手术组，对比分析两组的R0切除率、5年复发率及5年生存率等指标。诱导治疗组术后分期为Masaoka-Koga I期-II期的病例视为诱导治疗后降期。为更加精确评估诱导治疗效果，在剔除术后IV期病例的基础上，再次将诱导治疗组术后Masaoka-Koga I期-III期的病例与直接手术组Masaoka-Koga III期的病例进行对比分析。结果ChART回顾性数据库1,713例有效病例中，局部进展期胸腺瘤706例，仅68例（4%）作了术前诱导治疗，R0切除率为67.6%，5年复发率为44.9%，5年与10年生存率分别为49.7%和19.9%。其中17例诱导治疗后达到降期，降期亚组中胸腺瘤的比例高于胸腺癌（38.7%vs 13.9%,P=0.02）；与未降期亚组相比，降期亚组获得更高的5年生存率（93.8%vs 35.6%,P=0.013）。剔除术后IV期的病例后，直接手术组和诱导治疗组R0切除率接近（76.4%vs 73.3%,P=0.63），但5年生存率差异明显（85.2%vs 68.1%,P＜0.001），对于降期亚组，5年生存率优于直接手术组（93.8%vs 85.2%, P=0.438），未降期亚组5年生存率仅35.6%，明显差于降期亚组和直接手术组（P＜0.001）。结论术前诱导治疗目前尚未在局部进展期胸腺瘤中广泛应用，但ChART的回顾性数据研究显示通过有效的术前诱导治疗可以使难以彻底切除的病例降期后增加R0切除的机会，从而延长生存，特别是胸腺瘤的病例。这一初步结果将有助于未来的研究。 |
| Abstract_FL | 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). |
| Author | 魏煜程 谷志涛 沈毅 傅剑华 谭黎杰 张鹏 韩泳涛 陈椿 张仁泉 李印 陈克能 陈和忠 刘永煜 崔有斌 王允 庞烈文 于振涛 周鑫明 柳阳春 刘媛 方文涛 |
| AuthorAffiliation | 青岛大学医学院附属医院胸外科,青岛266001 上海交通大学附属上海胸科医院,上海200030 中山大学附属肿瘤医院胸外科,广州510060 复旦大学附属中山医院胸外科,上海200032 天津医科大学附属总医院胸外科,天津300052 四川省肿瘤医院胸外科,成都610041 福建医科大学附属协和医院胸外科,福州350001 安徽医科大学附属第一医院胸外科,合肥230022 郑州大学附属肿瘤医院胸外科,郑州450008 北京大学附肿瘤医院胸外科,北京100142 长海医院胸心外科,上海200433 辽宁肿瘤医院胸外科,沈阳110042 吉林大学附属第一医院胸外科,长春130021 四川大学华西医院胸外科,成都610041 复旦大学附属华山医院胸外科,上海200032 天津医科大学附属肿瘤医院食管癌中心,天津300060 浙江省肿瘤医院胸外科,杭州310022 江西省人民医院胸外科,南昌330006 |
| AuthorAffiliation_xml | – name: 青岛大学医学院附属医院胸外科,青岛,266001%上海交通大学附属上海胸科医院,上海,200030%中山大学附属肿瘤医院胸外科,广州,510060%复旦大学附属中山医院胸外科,上海,200032%天津医科大学附属总医院胸外科,天津,300052%四川省肿瘤医院胸外科,成都,610041%福建医科大学附属协和医院胸外科,福州,350001%安徽医科大学附属第一医院胸外科,合肥,230022%郑州大学附属肿瘤医院胸外科,郑州,450008%北京大学附肿瘤医院胸外科,北京,100142%长海医院胸心外科,上海,200433%辽宁肿瘤医院胸外科,沈阳,110042%吉林大学附属第一医院胸外科,长春,130021%四川大学华西医院胸外科,成都,610041%复旦大学附属华山医院胸外科,上海,200032%天津医科大学附属肿瘤医院食管癌中心,天津,300060%浙江省肿瘤医院胸外科,杭州,310022%江西省人民医院胸外科,南昌,330006 |
| Author_FL | Hezhong CHEN Chun CHEN Youbing CUI Yuan LIU Jianhua FU Yin LI Liejie TAN Xinming ZHOU Renquan ZHANG Zhentao YU Yi SHEN Liewen PANG Yucheng WEI Yongyu LIU Yun WANG Zhitao GU Yangchun LIU Yongtao HAN Ke-Neng CHEN Peng ZHANG Wentao FANG |
| Author_FL_xml | – sequence: 1 fullname: Yucheng WEI – sequence: 2 fullname: Zhitao GU – sequence: 3 fullname: Yi SHEN – sequence: 4 fullname: Jianhua FU – sequence: 5 fullname: Liejie TAN – sequence: 6 fullname: Peng ZHANG – sequence: 7 fullname: Yongtao HAN – sequence: 8 fullname: Chun CHEN – sequence: 9 fullname: Renquan ZHANG – sequence: 10 fullname: Yin LI – sequence: 11 fullname: Ke-Neng CHEN – sequence: 12 fullname: Hezhong CHEN – sequence: 13 fullname: Yongyu LIU – sequence: 14 fullname: Youbing CUI – sequence: 15 fullname: Yun WANG – sequence: 16 fullname: Liewen PANG – sequence: 17 fullname: Zhentao YU – sequence: 18 fullname: Xinming ZHOU – sequence: 19 fullname: Yangchun LIU – sequence: 20 fullname: Yuan LIU – sequence: 21 fullname: Wentao FANG |
| Author_xml | – sequence: 1 fullname: 魏煜程 谷志涛 沈毅 傅剑华 谭黎杰 张鹏 韩泳涛 陈椿 张仁泉 李印 陈克能 陈和忠 刘永煜 崔有斌 王允 庞烈文 于振涛 周鑫明 柳阳春 刘媛 方文涛 |
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| Copyright | Copyright © Wanfang Data Co. Ltd. All Rights Reserved. |
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| DocumentTitleAlternate | Preoperative Induction Therapy for Locally Advanced Thymic Tumors：A Retrospective Analysis Using the ChART Database |
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| Keywords | Thymic malignancy 局部进展 诱导治疗 胸腺瘤 Induction therapy Surgery 手术 Local progression 生存率 Survival |
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| Notes | 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- |
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| PublicationDate | 2016 |
| PublicationDateYYYYMMDD | 2016-01-01 |
| PublicationDate_xml | – year: 2016 text: 2016 |
| PublicationDecade | 2010 |
| PublicationTitle | 中国肺癌杂志 |
| PublicationTitleAlternate | Chinese Journal of Lung Cancer |
| PublicationYear | 2016 |
| Publisher | 青岛大学医学院附属医院胸外科,青岛,266001%上海交通大学附属上海胸科医院,上海,200030%中山大学附属肿瘤医院胸外科,广州,510060%复旦大学附属中山医院胸外科,上海,200032%天津医科大学附属总医院胸外科,天津,300052%四川省肿瘤医院胸外科,成都,610041%福建医科大学附属协和医院胸外科,福州,350001%安徽医科大学附属第一医院胸外科,合肥,230022%郑州大学附属肿瘤医院胸外科,郑州,450008%北京大学附肿瘤医院胸外科,北京,100142%长海医院胸心外科,上海,200433%辽宁肿瘤医院胸外科,沈阳,110042%吉林大学附属第一医院胸外科,长春,130021%四川大学华西医院胸外科,成都,610041%复旦大学附属华山医院胸外科,上海,200032%天津医科大学附属肿瘤医院食管癌中心,天津,300060%浙江省肿瘤医院胸外科,杭州,310022%江西省人民医院胸外科,南昌,330006 |
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| Snippet | 背景与目的探讨术前诱导治疗在胸腺瘤中的应用及其对局部进展期胸腺瘤预后的影响。方法收集中国胸腺肿瘤协作组（Chinese Alliance of Research for hTymomas, ChART）1994... |
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| StartPage | 445 |
| SubjectTerms | 局部进展 手术 生存率 胸腺瘤 诱导治疗 |
| Title | 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 |
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| Volume | 19 |
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