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Objective:To explore the prognostic risk factors of thymoma patients after resection, and establish a novel nomogram to predict progression free survival(PFS) of patients with thymoma.Methods:A retrospectively analysis was performed on clinicopathological datas of 267 cases of thymoma patients underwent thymoma resection in Beijing Tongren Hospital from January 2010 to December 2019. The univariate and multivariate Cox risk ratio models were used to analyze the related factors that might affect PFS, and the prediction nomogram of PFS after thymoma resection was established using the screened independent risk factors. Then the predictive ability of the model was evaluated. Results:The univariate analysis showed that age, type of surgery, completeness of resection, WHO histologic classification, TNM stage and postoperative adjuvant therapy were significantly correlated with PFS after thymoma resection( P<0.05). The multivariate analysis showed that only age and TNM stage were independent prognostic factors affecting PFS after thymoma resection( P<0.05). The concordance index( C- index) of the prediction model for the prognosis of thymoma patients established by this method was 0.866(95% CI: 0.809-0.923), which had remarkable predictive efficiency. Conclusion:The nomogram model is constructed and verified based on age and TNM stage, excluding the interference of other clinicopathological factors on prognosis assessment, and which is convenient for clinicians to quickly and individually evaluate the prognosis of patients after thymoma resection.
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Objective:To explore the prognosis and clinical risk factor of thymoma patients after resection.Methods:A retrospectively analysis of 154 cases of thymoma patients underwent thymoma resection in Beijing Tongren Hospital (Myasthenia Gravis & Thymoma Diagnosis and Treatment Center, Capital Medical University) from January 2005 to December 2015, and then the progress-free survival was calculated by Kaplan- Meier method, the differences between curves were analyzed by log- rank test. There were 74 males and 80 females; the median age was 52(22-77)years. 121 cases(78.6%)complicated with myashenia gravis. Thymoma cases were classfied into 5 cases A, 35 cases AB, 27 cases B1, 56 cases B2 and 31 cases B3 respectively. There were 80, 16, 45 and 13 patients with Masaoka-Koga type Ⅰ-Ⅳ, respectively. 122 cases were treated by thoracoscopic assisted operation, 32 cases were treated by median sternum. The risk factors about group of gender, age, thymoma-associated MG (Myasthenia Gravis), completeness of resection, histologic type and Masaoka-Koga stage were calculated by Cox regression analysis. Results:The overall 1-, 5- 10-year progress-free survival rate of 154 cases were 98.7%, 88.3%, and 78.7%, respectively. The adverse prognostic factors for progress-free survival were age, completeness of resection, WHO histologic classification and Masaoka-Koga stage at univariate analysis. The age, WHO histologic classification and Masaoka-Koga stage were the independent risk factors at multivariate analysis.Conclusion:For thymoma, we suggest early discovery and early treatment. For the thymoma patients who are available for surgical treatment, all the tumor, thymus and surrounding adipose tissue should be resected. For the thymoma patients whose tumors cannot excise completely, adjuvant radiotherapy can reduce the risk for tumor recurrence after resection. For patients with thymoma after surgery, MG treatment is particularly critical for prognosis.
ABSTRACT
As a thymoid-related autoimmune disease, thymectomy has become one of the effective treatments for MG. We review the surgical indications of MG in this artical.