Clinical features and prognosis of thymoma with myasthenia gravis:an analysis of 126 patients
Wang Lihuan,Wang Wei,Chen Yuping,Zhang Yuhai,Meng Shaolin,Li Yang,Li Yuemin
Department of Radiation Oncology (Wang LH,Zhang YH,Meng SHL,Li YM),Departmentof Neurology (Wang W,Chen YP),No.309 Hospital of PLA,Beijing 100091,China;Graduate Division of Hebei North University,Zhangjiakou 075000,China (Wang LH);Institute of Radiation Medicine,Military Academy of Medical Sciences,Beijing 100850,China (Li Y)
Abstract：Objective To investigate the clinical and pathological features and prognostic factors for thymoma with myasthenia gravis (MG). Methods The clinical and pathological data of 126 patients with thymoma and MG confirmed by postoperative pathological examination from 2008 to 2014 were analyzed retrospectively. The Kaplan-Meier method was used to calculate survival rates;the log-rank test was applied for univariate prognostic analysis;the Cox regression model was applied for multivariate prognostic analysis. Results The numbers of patients who received the follow-up visits at 3 and 5 years were 88 and 45, respectively (the patients who were admitted before the end of October 2011 and the end of October 2009). The 3-and 5-year survival rates were 97.9% and 91.8%, respectively. The 3-and 5-year survival rates for patients with WHO types A+AB+B1+B2 and B3 were 98.6%/95.2% and 90.6%/92.9%, respectively (P=0.764), and those for patients with Masaoka stages Ⅰ-Ⅱ and Ⅲ-IV were 98.6%/95.2% and 97.4%/72.7%, respectively (P=0.791). The 3-and 5-year survival rates for patients with complete and partial resection were 97.8%/91.7% and 100.0%/50.0%, respectively (P=0.964), and those for patients with complete resection alone and complete resection+postoperative radiotherapy were 96.8%/93.1% and 100.0%/94.7%, respectively (P=1.000). Conclusions The major treatment modality for thymoma with MG is complete resection followed by radiotherapy according to the specific circumstances after surgery. Complete resection, postoperative radiotherapy, WHO type, and Masaoka stage may be associated with prognosis.
Wang Lihuan,Wang Wei,Chen Yuping et al. Clinical features and prognosis of thymoma with myasthenia gravis:an analysis of 126 patients[J]. Chinese Journal of Radiation Oncology, 2016, 25(1): 37-41.
[1]RomiF. Thymomainmyastheniagravis:fromdiagnosistotreatment[J].AutoimmuneDis,2011,5(7):474-512.DOI:10.4061/2011/474512. [2]ErinMC,PatrickJK,PatrickJL.Clinical Management of thymoma patients[J].Hematol Oncol Clin,2008,22(21):457-473.DOI:10.1016/i.hoc.2008.03.010. [3]SpaggiariL,CasiraghiM,GuarizeJ.Multidisciplinary treatment of malignantthymoma. Curr Opin Oncol,2012,24:117-122. [4]侯秀玉,徐勇刚,高鸿,等.放疗恶性胸腺瘤对合并的重症肌无力的影响[J].中华放射肿瘤学杂志,2006,15(1):28-30. Hou XY,Xu YG,Gao H,et al. Radiation therapy of malignant thymomas in patients with myasthenia gravis[J].Chin J Radiat Oncol,2006,15(1):28-30. [5]Travis W,Brambilla W,Muller-Hermelink H,et al. World health organizaion classification of tumors. Pathology and genetics of tumors of the lung,pleura,thymusandheart[M].Lyon:IARCpress,2004. [6]吴开良,蒋国梁,茅静芳,等.259例胸腺瘤术后放疗长期生存结果及预后因素分析[J].中华放射肿瘤学杂志,2005,14(6):467-450. Wu KL,Jiang GL,Mao JF,et al. The long-term outcome of postoperative radiotherapy and prognostic factors in 259 thymoma patients[J].Chin J Radiat Oncol,2005,14(6):467-450. [7]陈玉萍,王卫,王中魁,等.重症肌无力伴发胸腺瘤患者的临床特点分析[J].中华内科杂志,2012,51(8):623-625.DOI:10.3760/cma.j.issn.0578-1426.2012.08.012. Chen YP,Wang W,Wang WK,et al. The clinical characteristics of patients with thymoma-associated myasthenia gravis[J].Chin J Inter Med,2012,51(8):623-625.DOI:10.3760/cma.j.issn.0578-1426.2012.08.012. [8]Venuta F,Rendina EA,Anile M,etal. Thymoma and thymic carcinoma[J].Gen Thorac Cardiovasc Surg,2012,1(1):1-12.DOI:10.1007/s11748-011-0814-0. [9]张晓峰,张其刚.185例胸腺瘤的临床特点[J].中国胸心血管外科临床杂志,2007,14(2):108-111. Zhang XF,Zhang QG.Clinical Characteristics of 185 Case of Thymoma[J].Chin J Clin Thorac Cardio vasc Surg,2007,14(2):108-111. [10]曾涟乾,黄壮士,张斌.胸腺瘤与胸腺瘤合并重症肌无力的临床探讨[J].中华胸心血管外科杂志,2003,19(1):19-20.Zeng LQ, Huang ZS, Zhang B, Clinical study on thymomas and thymomas with myasthenia gravis[J].Chin J Thorac Cardiovasc Surg, 2003,19(1):19-20 [11]Restrepo CS,Pandit M,Rojas IC,et al. Imagingfindingsofexpansilelesionsofthethymus[J].Curr Probl Diagn Radiol,2005,34(1):22-34. [12]Okumura M,Miyoshi S,Fujii Y,et al. Clinical and functional significance of WHO classification on human thymicepithelial neoplasms:astudy of 146 consecutive tumors[J].AmJ Surg Pathol,2001,25(2):103-110. [13]Maggi L,Andreetta F,Antozzi C,et al. Thymoma-associated myastheniagravis:outcome,clinical and pathological correlations in 197 patients on a 20-yeare xperience[J].J Neuroimmunol,2008,21(16):201-202,237-244. [14]杜俊,杨丽,刘东戈.胸腺瘤WHO新分类与重症肌无力的关系[J].中国神经免疫学和神经病学杂志,2008,15(4):384-386.DOI:10.3969/j.issn.1006-2963.2008.05.019. Du J,Yang L,Liu DG.The relationship between new WHO type of thymoma and myasthenia gravis[J].Chin J Neuroimmunol and Neurol,2008,15(4):384-386.DOI:10.3969/j.issn.1006-2963.2008.05.019. [15]Kondo K,Monden Y.Thymomaand myasthenia gravis:a clinical study of 1089 patients from Japan[J].Ann Thorac Surg,2005,79(12):219-224. [16]Vachlas K,Zisis C,Rontogianni D,et al. Thymomaand myastheniagravis:clinical aspects and prognosis[J].Asian Cardiovasc Thorac Ann,2012,20(1):48-52.DOI:10.1177/0218492311433189. [17]Filosso P,Venuta F,Oliaro A,et al. Thymoma and inter-relationship between clinical variables:amulticenter study in 537 patients[J].Eur J Cardio-Thorac Surg,2014,45(17):1020-1027.DOI:10.1093/ejcts/ezt567. [18]Kondo K,Monden Y.Therapy for thymic epithelial tumors:a clinical study of 1,320 patients from Japan[J].Ann Thorac Surg,2003,76(1):878-885. [19]Falkson CB,Bezjak A,Darling G,et al. The management of thymoma:a systematic review and practice guideline[J].J Thorac Oncol,2009,4(7):911-919.DOI:1556-0864/09/0407-0911. [20]Maggi G,Casadio C,Cavallo A,et al. Thymoma:results of 241 operated cases[J].Ann Thorac Surg,1991,51(7):152-156.
2016, Vol. 25 
