胸腺类癌外科治疗的长期结果_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GUO Feng , ZHANG Zhiyong , CUI Yushang

Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &;
Peking Union Medical College, Beijing 100730, P.R.China. E-mail: guofenglihui2003@yahoo.com.cn;

Corresponding author：

Keywords：

Thymic carcinoid; Tumor; Thymoma; Surgery

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate and evaluate the clinical manifestation, classification, surgical management and postoperative adjuvant therapy of thymic carcinoid, so as to improve the knowledge of the disease. Methods From January 1980 to January 2006, the outcome of surgery and follow-up of 18 cases of thymic carcinoid surgically intervened were retrospectively analysed. In this series, there were 2? exploratory thoracotomy, 2 partial or incomplete resection and 14 complete resections, which included 2 superior vena cava removal and reconstruction. The survival probabilities were calculated by the life tables, and a multivariable analysis of prognosis factors for thymic carcinoid was carried out using Cox regression model. Results Two patients who underwent exploratory thoracotomy died within one year and two years postoperatively respectively, 2 with partial or incomplete resection obtained temporary symptomatic improvement, 1 of 14 performed complete resections associated with Cushing’s syndrome died of septicemia in two weeks postoperatively, and the other 13 cases were in good condition by follow-up of 5 months to 15 years. The survival rate of 3, 5 and 10 years were 72.6%, 60.5% and 40.3%, respectively. According to Cox regression analysis, the factors of influence upon prognosis included lymph node metastasis(P=0047), pathological type(P=0.000), mode of resection (P=0.000) and postoperative adjuvant treatment(P=0018). Conclusion The thymic carcinoid is different from thymoma or thymic carcinoma, and there exist some difficulty in differential diagnosis. It is divided into typical and atypical thymic carcinoid in pathology, There are obvious differences in clinical manifestation and prognosis between typical and atypical carcinoid. The atypical thymic carcinoid has higher malignancy, frequent recurrence or metastasis, and poor prognosis. Complete resection of tumor with the involved surroundings could improve the long-term survival. The adjuvant radiotheraphy and chemotheraphy postoperatively would be benefit to the patients.

Citation： GUO Feng,ZHANG Zhiyong,CUI Yushang,LI Shanqing,LI Li,XU Xiaohui. 胸腺类癌外科治疗的长期结果. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2007, 14(6): 422-. doi: Copy

1.	Rosai J, Higa E. Mediastinal endocrine neoplasm of probable thymic origin, related to carcinoid tumor. Clinicopathologic study of 8 cases. Cancer, 1972, 29(4):1061-1074.
2.	Detterbeck FC, Parsons AM. Thymic? tumors. Ann Thorac Surg, 2004, 77(5): 1860-1869.
3.	张志庸,郝武森,任华,等. 胸腺类癌(附7例报告). 中华肿瘤杂志, 1992, 14(5): 382-384.
4.	黄进丰,汪良骏,李鉴,等.胸腺类癌4例. 中华胸心血管外科杂志, 1999, 15(6): 363.
5.	朱全,陈广明,朱宁. 胸腺类癌的外科治疗. 中国肿瘤临床与康复, 2001, 8(3): 85-86.
6.	钟华,陈岗,韩宝惠.8例胸腺类癌的临床分析. 肿瘤学杂志, 2002, 8(4): 236-237.
7.	de Perrot M, Spiliopoulos A, Fischer S, et al. Neuroendocrine carcinoma (carcinoid) of the thymus associated with Cushing’s syndrome. Ann Thorac Surg, 2002, 73(2):675-681.
8.	Filosso PL, Actis Dato GM, Ruffini E, et al. Multidisciplinary treatment of advanced thymic neuroendocrine carcinoma (carcinoid): Report of a successful case and review of the literature. J Thorac Cardiovasc Surg, 2004,127(4): 1215-1219.
9.	Liu HC, Hsu WH, Chen YJ, et al. Primary thymic carcinoma. Ann Thorac Surg,2002,73(4): 1076-1081.??.
10.	Markou A, Manning P, Kaya B, et al. [18F]fluoro-2-deoxy-D-glucose ([18F]FDG) positron emission tomography imaging of thymic carcinoid tumor presenting with recurrent Cushing’s syndrome. Eur J Endocrinol, 2005,152(4): 521-525.
11.	Arrigoni MG, Woolner LB, Bernatz PE. Atypical carcinoid tumors of the lung. J Thorac Cardiovasc Surg,1972,64(3): 413-421.
12.	Travis WD, Rush W, Flieder DB, et al. Survival analysis of 200 pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol, 1998, 22(8): 934-944.
13.	Rosai J, Sobin LH. World Health Organization International Histological Classification of Tumors: Histological Typing of Tumors of the Thymus, 2nd ed. Berlin: Springer Verlag, 1999. 15-18.
14.	Gal AA, Kornstein MJ, Cohen C, et al. Neuroendocrine tumors of the thymus: a clinicopathological and prognostic study. Ann Thorac Surg, 2001, 72(4):1179-1182.
15.	Sakuragi T, Rikitake K, Nastuaki M, et al.Complete resection of recurrent thymic carcinoid using cardiopulmonary bypass. Eur J Cardiothorac Surg, 2002, 21(1):152-154.
16.	Chaer R, Massad MG, Evans A, et al. Primary neuroendocrine tumors of the thymus. Ann Thorac Surg, 2002, 74(5):1733-1740.
17.	Tiffet O, Nicholson AG, Ladas G, et al. A clinicopathologic study of 12 neuroendocrine tumors arising in the thymus. Chest, 2003,124(1):141-146.

1. 　Rosai J, Higa E. Mediastinal endocrine neoplasm of probable thymic origin, related to carcinoid tumor. Clinicopathologic study of 8 cases. Cancer, 1972, 29(4):1061-1074.
2. 　Detterbeck FC, Parsons AM. Thymic? tumors. Ann Thorac Surg, 2004, 77(5): 1860-1869.
3. 　张志庸,郝武森,任华,等. 胸腺类癌(附7例报告). 中华肿瘤杂志, 1992, 14(5): 382-384.
4. 　黄进丰,汪良骏,李鉴,等.胸腺类癌4例. 中华胸心血管外科杂志, 1999, 15(6): 363.
5. 　朱全,陈广明,朱宁. 胸腺类癌的外科治疗. 中国肿瘤临床与康复, 2001, 8(3): 85-86.
6. 　钟华,陈岗,韩宝惠.8例胸腺类癌的临床分析. 肿瘤学杂志, 2002, 8(4): 236-237.
7. 　de Perrot M, Spiliopoulos A, Fischer S, et al. Neuroendocrine carcinoma (carcinoid) of the thymus associated with Cushing’s syndrome. Ann Thorac Surg, 2002, 73(2):675-681.
8. 　Filosso PL, Actis Dato GM, Ruffini E, et al. Multidisciplinary treatment of advanced thymic neuroendocrine carcinoma (carcinoid): Report of a successful case and review of the literature. J Thorac Cardiovasc Surg, 2004,127(4): 1215-1219.
9. 　Liu HC, Hsu WH, Chen YJ, et al. Primary thymic carcinoma. Ann Thorac Surg,2002,73(4): 1076-1081.??.
10. 　Markou A, Manning P, Kaya B, et al. [18F]fluoro-2-deoxy-D-glucose ([18F]FDG) positron emission tomography imaging of thymic carcinoid tumor presenting with recurrent Cushing’s syndrome. Eur J Endocrinol, 2005,152(4): 521-525.
11. 　Arrigoni MG, Woolner LB, Bernatz PE. Atypical carcinoid tumors of the lung. J Thorac Cardiovasc Surg,1972,64(3): 413-421.
12. 　Travis WD, Rush W, Flieder DB, et al. Survival analysis of 200 pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol, 1998, 22(8): 934-944.
13. 　Rosai J, Sobin LH. World Health Organization International Histological Classification of Tumors: Histological Typing of Tumors of the Thymus, 2nd ed. Berlin: Springer Verlag, 1999. 15-18.
14. 　Gal AA, Kornstein MJ, Cohen C, et al. Neuroendocrine tumors of the thymus: a clinicopathological and prognostic study. Ann Thorac Surg, 2001, 72(4):1179-1182.
15. 　Sakuragi T, Rikitake K, Nastuaki M, et al.Complete resection of recurrent thymic carcinoid using cardiopulmonary bypass. Eur J Cardiothorac Surg, 2002, 21(1):152-154.
16. 　Chaer R, Massad MG, Evans A, et al. Primary neuroendocrine tumors of the thymus. Ann Thorac Surg, 2002, 74(5):1733-1740.
17. 　Tiffet O, Nicholson AG, Ladas G, et al. A clinicopathologic study of 12 neuroendocrine tumors arising in the thymus. Chest, 2003,124(1):141-146.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

胸腺类癌外科治疗的长期结果

Abstract Full text Figures/Tables Video References Cited by

Format

Content