Study On The Clinicopathological Characteristics And Prognostic Influencing Factors Of Thymoma

Background and purpose:Thymoma is a type of rare tumor that occurs well in the anterior mediastinal compartment and is often associated with inert growth and various paraneumour syndromes.According to the literature reports,many thymomas previously considered benign have certain malignant characteristics and appear malignant behaviors of local invasion and distant metastasis,so all thymomas are currently regarded as malignant tumors.The prognostic factors reported in the literature include age,tumor diameter,WHO typing,Masaoka-Koga stage,TNM stage,myasthenia gravis(MG),surgical treatment and non-surgical treatment,but different studies presents different results.Therefore,we should be actively analysed about the clinicopathological characteristics of thmoma and explored the overall survival time and recurrence and metastasis to improve patient outcomes.Materials and Methods:The case data were consulted through the disease browser,electronic medical record system and imaging system,and the clinicopathological data of patients with thymomas(type A,AB,B1,B2 and B3)treated in Sichuan Cancer Hospital from March2015 to March 2021 were collected,and their prognosis was followed up by telephone.Review literature to develop clinical baseline data and related prognostic factors,apply Excell2019 for data collection and management,and SPSS17.0 for statistical analysis.The progression-free survival time(PFS)and overall survival time(OS)in thymomas were estimated using the Kaplan-Meier method,And survival analysis of univariate categorized variables and survival curves for each alternative factor,Differdifferences between groups were compared using the log-rank method(Log-rank test),Variables with P<0.05 were included in the multivariate analysis,Multivariate analysis of corresponding variables using Cox proportional risk regression model was used,differences were statistically significant and expressed as P <0.05.Result:1.The study included 177 patients for statistical analysis,including 17 who died of thymus,160 surviving patients and 5 with recurrent metastasis.2.According to WHO classification,type AB was the most common in 74(41.8%),followed by 54 B2(28.8%),23 B3(12.9%),19 A(10.7%)and 10 B1(5.6%).Overall,there were 93 cases of type A and AB,accounting for 52.5%,and 84 cases of type B(including B1 / B2 / B3),accounting for 47.5%.3.According to Masaoka-Koga stage: 110 cases in stage I(62.1%),11 cases in stage II(6.2%),33 cases in stage III(18.6%),23 cases in stage IV(12.9%),121 cases in stage I and II(68.4%),56 cases in stage III and IV(31.6%).4.There were 160 patients treated with surgical operation,accounting for 90.4%and 17 with unoperated,accounting for 9.6%.There were 29 patients treated with radiotherapy(16.4%),5 cases with chemotherapy(2.8%)and 29 patients with chemoradiotherapy(16.4%).In groups,114 patients had treated with operation only(64.4%),46 patients with operation and adjunctive therapy(26.0%)and 17 patients with adjunctive therapy only(9.6%).5.There were 16 patients(9.0%)with macrovascular invasion and 161 patients(91.0%)without macrovascular invasion.The tumor had a maximum diameter of 18 cm with a mean value of 6.37 cm,more than half of the patients(102 patients,57.6%)had a tumor diameter greater than 6cm.There were 24 patients with myasthenia gravis(13.5%)and most patients had clinical symptoms(101 patients,57.1%).6.The 1-year PFS about thymoma was 94.4%,OS 94.9%,3-year PFS 88.7%,OS91.5%,and 5-year PFS 88.1% and OS 91.0%.7.The results of univariate analysis showed that WHO classification,treatment modalities,Masaoka-Koga stage,presence of clinical symptoms,and whether surgery were statistically different for thymoma PFS.Age,treatment modality,having any clinical symptoms,and having surgery were statistically different in thymoma OS.Clinical symptoms,treatment modalities,and whether surgery were statistically different in thymoma PFS and OS.8.The results of multivariate analysis showed that age,clinical symptoms and treatment mode are the independent influencing factors of thymoma OS,and the treatment mode is also the independent influencing factors in PFS of thymoma.Conclusion:1.The age of thymoma patients,clinical symptoms and treatment modality were independent influencing factors for their prognostic OS.The treatment modality were an independent influence of prognostic PFS in thymomas.The patients about younger,with surgical and without clinical symptoms have longer OS in thymoma.The patients about surgical have longer PFS in thymoma.2.Treatment modality is an independent factor affecting the prognosis of patients with thymoma.Surgical treatment is preferred for operable patients.Combination with chemoradiotherapy also provides a good survival benefit for patients who cannot undergo surgery alone.3.This study showed that Masaoka-Koga stage and WHO classification were not independent prognostic factors in thymoma patients,but may be prognostic factors for PFS in patients with thymoma.