New WHO histologic classification predicts prognosis of thymic epithelial tumors: a clinicopathologic study of 200 thymoma cases from China.

摘要: BACKGROUND In 1999, a World Health Organization (WHO) committee published histologic criteria for distinct thymoma entities (labeled as Type A, AB, B1, B2, B3 thymomas) and the heterogeneous group of thymic carcinomas, collectively called C thymomas. Whether WHO-defined subtypes are independent prognostic relevance has yet to be proved. METHODS Two hundred thymomas from Shanghai Chest Hospital with mean follow-up time 15 years (range, 1–246 months) were studied WHO subtype other factors (stage, therapy, myasthenia gravis [MG]) survival. RESULTS In order frequency, 68 patients (34.0%) had 39 (19.5%) 36 (18.0%) C, 27 (13.5%) B3, 17 (8.5%) 8 (4.0%) A thymoma. Five cases (2.5%) rare not mentioned in classification. Survival data showed significant differences among (log rank test: P < 0.001). Among AB thymomas, none died tumor; B1 patients, only one (5.9%) at 22 months. significantly worse prognosis 5-year survival rates 75.0%, 70.0%, 48.0%, respectively. Ninety-six (48.0%) Masaoka Stage I, 26 (13.0%) II, 65 (32.5%) III, 13 (6.5%) IV. was highly predicting rank, test The association between invasive behavior (stage) statistically (P However, histology an predictive factor I II thymomas: than 0.003). Thirty (15.0%) presented MG. MG more frequent B2 0.01). On multivariate analysis, no adverse effect on = 0.17). Radiation or chemotherapy improved patients' 5 10 0.003). CONCLUSIONS Tumor stage is most important determinant but which form low-risk group. Patients high-risk might profit novel adjuvant radiochemotherapy regimens. Cancer 2002;95:420–9. © 2002 American Society. DOI 10.1002/cncr.10665