Effect of Lymph Node Dissection on the Prognosis of Thymic Carcinomas and Thymic Neuroendocrine Tumors
| Autor: | Xin Ying Liu, Feng Li, Zi Ming Wang, Mahmoud Ismail, Dania Nachira, Jens C. Rückert, Harun Badakhshi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Oncology medicine.medical_specialty Thymoma 030204 cardiovascular system & hematology Neuroendocrine tumors Metastasis 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Surveillance Epidemiology and End Results Overall survival Humans Lymph node Neoplasm Staging business.industry fungi Hazard ratio General Medicine Thymus Neoplasms medicine.disease Prognosis Dissection Neuroendocrine Tumors medicine.anatomical_structure 030228 respiratory system Propensity score matching Lymph Node Excision Surgery Lymph Nodes Cardiology and Cardiovascular Medicine business |
| Zdroj: | Seminars in thoracic and cardiovascular surgery. 33(2) |
| ISSN: | 1532-9488 |
| Popis: | We aimed to analyze the effect of lymph node dissection (LND) and accurate lymph node (LN) status on the survival and prognosis of patients with thymic carcinomas (TCs) and thymic neuroendocrine tumors (TNETs) undergoing surgical treatment. The Surveillance, Epidemiology, and End Results database was queried for patients who underwent surgical resection for TCs and TNETs during 1998-2016. LN status were defined as no LND (LND-), pathologically negative with LND (N0), and LN metastasis positive (N+). We investigated outcomes of LN status together with other clinicopathological features for overall survival (OS). Subgroup analyses were performed between LND-, N0, and N+ cohorts using propensity score matching, to analyze the significance of LND in prognosis. A total of 812 patients were enrolled, including 623 with TCs and 189 with TNETs. The proportion of LN metastasis positive in TNETs was 58.8% which was significantly higher than that in TCs (30%) (P0.001). In multivariable Cox analysis of OS, patients with LND- had a significantly worse prognosis than those with N0 (P = 0.018); there was no difference between N+ and LND- (P = 0.560). After propensity score matching, patients with N0 still had better survival than those with LND- and N+ in subgroup univariable and multivariable analyses of OS; however, the survival of patients with LND- and N+ was not significantly different in multivariable analysis. It was demonstrated that LND in TCs and TNETs can clarify the status of LN metastasis, to more accurately evaluate patients' long-term prognosis. |
| Databáze: | OpenAIRE |
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