Inter-relationship among myasthenia gravis, WHO histology, and Masaoka clinical stage and effect on surgical methods in patients with thymoma: a retrospective cohort study

doi:10.21037/jtd.2018.05.30

科研成果详情

题名	Inter-relationship among myasthenia gravis, WHO histology, and Masaoka clinical stage and effect on surgical methods in patients with thymoma: a retrospective cohort study
作者	Shen, Jianfei1; Tie, Hongtao 2; Xu, Anyi 3; Chen, Dan 2; Ma, Dehua1; Zhang, Bo1; Zhu, Chengchu1; Wu, Qingchen 2
发表日期	2018-05
发表期刊	JOURNAL OF THORACIC DISEASE 影响因子和分区
语种	英语
原始文献类型	Article
关键词	Thymoma myasthenia gravis (MG) thoracoscopic thymectomy open thymectomy
其他关键词	ASSISTED THORACOSCOPIC SURGERY ; OPEN THYMECTOMY ; CLASSIFICATION ; STERNOTOMY
摘要	Background: The aim of study is to analyze the inter-relationship among WHO histology, myasthenia gravis (MG) and Masaoka stage and to assess the feasibility of thoracoscopic surgery in thymoma patients. Methods: Data from 142 consecutive thymoma patients from January 2009 to March 2016 were retrospectively reviewed in our institution. Histological classification and clinical staging were assessed by WHO histology criteria and Masaoka stage. We investigated the clinical characteristics, inter-relationship among WHO histology, MG and Masaoka stage, and compared the feasibility and safety of thoracoscopic thymectomy by comparison of open thymectomy. Results: Among 142 patients, the incidence of MG was 29.6%. Compared with A and AB-type thymomas, a higher prevalence of advance clinical stage was in B1 to C-type thymomas (37/63 vs. 9/43, P<0.001), and there was an increased trend of Masaoka stage from A to C-type thymomas (P<0.001). The incidence of MG was significantly higher in AB, B1 and B2-type thymomas than other type thymomas (23/63 vs. 6/44, P=0.009) and in early Masaoka clinical stage than advanced Masaoka clinical stage (29/80 vs. 12/59, P=0.042). Thoracoscopic surgery could significantly decrease blood loss in patients with (104.06 +/- 137.36 vs. 350.91 +/- 560.79 mL, P=0.001) or without MG (91.90 +/- 77.70 vs. 266.32 +/- 292.60 mL, P=0.02), with comparable complications. Additionally, thoracoscopic surgery could achieve an equal effect on the remission of MG with open surgery (7/11 vs. 10/14, P=1.000), and Masaoka stage was significantly associated with the remission of MG after thymectomy. Conclusions: Our study suggests that WHO histology, MG, and Masaoka stage interrelate with one another, and Masaoka stage is an important prognostic factor in remission of MG after thymectomy in thymoma patients. Thoracoscopic thymectomy could achieve an equal efficacy to open thymectomy and should be recommended as a routine surgery for patients with early Masaoka
资助项目	Zhejiang Provincial Natural Science Foundation of ChinaNatural Science Foundation of Zhejiang Province [LQ18H160029]; Taizhou Postdoctoral Science Foundation [201702]
出版者	AME PUBL CO
出版地	SHATIN
ISSN	2072-1439
EISSN	2077-6624
卷号	10 期号:5 页码:2981-+
DOI	10.21037/jtd.2018.05.30
页数	11
WOS类目	Respiratory System
WOS研究方向	Respiratory System
WOS记录号	WOS:000435834200074
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	29997965
PMC记录号	PMC6006062
SCOPUSEID	2-s2.0-85047983815
通讯作者地址	[Zhu, Chengchu]Department of Thoracic Surgery,Taizhou Hospital of Zhejiang Province,Wenzhou Medical University,Linhai,317000,China
Scopus学科分类	Pulmonary and Respiratory Medicine
引用统计	被引频次：8[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/18574
专题	第一临床医学院（信息与工程学院）、附属第一医院_急诊医学
通讯作者	Zhu, Chengchu
作者单位	1.Department of Thoracic Surgery,Taizhou Hospital of Zhejiang Province,Wenzhou Medical University,Linhai,317000,China; 2.Department of Cardiothoracic Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing,400042,China; 3.Department of Emergency Medicine,Taizhou Hospital of Zhejiang Province,Wenzhou Medical University,Linhai,317000,China
推荐引用方式 GB/T 7714	Shen, Jianfei,Tie, Hongtao,Xu, Anyi,et al. Inter-relationship among myasthenia gravis, WHO histology, and Masaoka clinical stage and effect on surgical methods in patients with thymoma: a retrospective cohort study[J]. JOURNAL OF THORACIC DISEASE,2018,10(5):2981-+.
APA	Shen, Jianfei., Tie, Hongtao., Xu, Anyi., Chen, Dan., Ma, Dehua., ... & Wu, Qingchen. (2018). Inter-relationship among myasthenia gravis, WHO histology, and Masaoka clinical stage and effect on surgical methods in patients with thymoma: a retrospective cohort study. JOURNAL OF THORACIC DISEASE, 10(5), 2981-+.
MLA	Shen, Jianfei,et al."Inter-relationship among myasthenia gravis, WHO histology, and Masaoka clinical stage and effect on surgical methods in patients with thymoma: a retrospective cohort study".JOURNAL OF THORACIC DISEASE 10.5(2018):2981-+.