Lymph node metastasis in thymic malignancies: A Chinese multicenter prospective observational study
To study the incidence and pattern of lymph node metastases in thymic malignancies. This multicenter prospective observational trial with intentional lymph node dissection was carried out by the Chinese Alliance for Research in Thymomas (ChART). Data on patients with thymic tumors without pretreatme...
Gespeichert in:
| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2018-08, Vol.156 (2), p.824-833.e1 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 833.e1 |
|---|---|
| container_issue | 2 |
| container_start_page | 824 |
| container_title | The Journal of thoracic and cardiovascular surgery |
| container_volume | 156 |
| creator | Fang, Wentao Wang, Yun Pang, Liewen Gu, Zhitao Wei, Yucheng Liu, Yongyu Zhang, Peng Chen, Chun Zhou, Xinming Liu, Yangchun Chen, Keneng Ding, Jianyong Han, Yongtao Li, Yin Yu, Zhentao Liu, Yuan Fu, Jianhua Shen, Yi Wei, Yucheng Li, Yin Liang, Guanghui Chen, Keneng Fu, Hao Chen, Hezhong Yao, Shihua Cui, Youbin Xin, Yanzhong Zhang, Renquan Kang, Ningning Tan, Lijie Ding, Jianyong Wang, Hao Chen, Gang Wu, Jie Chen, Chun Zheng, Wei Pang, Liewen Wang, Fangrui Liu, Yangchun Lin, Qing Liu, Yongyu Wu, Yongkai Fang, Wentao Zhang, Jie Shen, Yan Wang, Changlu Zhu, Lei Gu, Zhitao Han, Yongtao Peng, Lin Fu, Jianhua Liu, Qianwen Yu, Zhentao Yue, Jie Zhang, Peng Chen, Yuan Wang, Yun Geng, Yingcai Zhou, Xinming Zhao, Hongguang |
| description | To study the incidence and pattern of lymph node metastases in thymic malignancies.
This multicenter prospective observational trial with intentional lymph node dissection was carried out by the Chinese Alliance for Research in Thymomas (ChART). Data on patients with thymic tumors without pretreatment were collected prospectively. Results from this prospective study were then compared with those from a previously reported ChART retrospective study.
Among 275 patients, metastasis was detected in 41 nodes (3.04%) in 15 patients (5.5%). The rate of lymph node metastasis was 2.1% (5/238) in patients with thymomas, 25% (6/24) in those with thymic carcinomas, and 50% (4/8) in those with neuroendocrine tumors (P |
| doi_str_mv | 10.1016/j.jtcvs.2018.04.049 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2042233951</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022522318310341</els_id><sourcerecordid>2042233951</sourcerecordid><originalsourceid>FETCH-LOGICAL-c404t-594f2a4f7f5500812817dff19125d1db7e8ed243b29338b73e34a7a8f9e351d13</originalsourceid><addsrcrecordid>eNp9kEtrGzEURkVpaNy0v6BQtOxmnKvHRKNAF8G0TcCQTQLZCY10J5aZ0TgjjcH_PnKcdln44G7OfR1CvjFYMmBXl9vlNrt9WnJgzRJkif5AFgy0qq6a-ukjWQBwXtWci3PyOaUtAChg-hM551qpRghYELc-DLsNjaNHOmC2qSQkGiLNm8MQHB1sH56jjS5guqY3dLUJEVOB5z4HhzHjRHfTmHboctgjHduE097mMEbb05Rnf_hCzjrbJ_z6Xi_I4-9fD6vban3_5251s66cBJmrWsuOW9mprq4BGsYbpnzXMc147ZlvFTbouRQt10I0rRIopFW26TSKmnkmLsiP09xyz8uMKZshJId9byOOczIcZHEhdH1ExQl15fQ0YWd2UxjsdDAMzNGu2Zo3u-Zo14As0aXr-_uCuR3Q_-v5q7MAP08Aljf3ASeTirfo0Iep-DF-DP9d8ApZbY3e</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2042233951</pqid></control><display><type>article</type><title>Lymph node metastasis in thymic malignancies: A Chinese multicenter prospective observational study</title><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Fang, Wentao ; Wang, Yun ; Pang, Liewen ; Gu, Zhitao ; Wei, Yucheng ; Liu, Yongyu ; Zhang, Peng ; Chen, Chun ; Zhou, Xinming ; Liu, Yangchun ; Chen, Keneng ; Ding, Jianyong ; Han, Yongtao ; Li, Yin ; Yu, Zhentao ; Liu, Yuan ; Fu, Jianhua ; Shen, Yi ; Wei, Yucheng ; Li, Yin ; Liang, Guanghui ; Chen, Keneng ; Fu, Hao ; Chen, Hezhong ; Yao, Shihua ; Cui, Youbin ; Xin, Yanzhong ; Zhang, Renquan ; Kang, Ningning ; Tan, Lijie ; Ding, Jianyong ; Wang, Hao ; Chen, Gang ; Wu, Jie ; Chen, Chun ; Zheng, Wei ; Pang, Liewen ; Wang, Fangrui ; Liu, Yangchun ; Lin, Qing ; Liu, Yongyu ; Wu, Yongkai ; Fang, Wentao ; Zhang, Jie ; Shen, Yan ; Wang, Changlu ; Zhu, Lei ; Gu, Zhitao ; Han, Yongtao ; Peng, Lin ; Fu, Jianhua ; Liu, Qianwen ; Yu, Zhentao ; Yue, Jie ; Zhang, Peng ; Chen, Yuan ; Wang, Yun ; Geng, Yingcai ; Zhou, Xinming ; Zhao, Hongguang</creator><creatorcontrib>Fang, Wentao ; Wang, Yun ; Pang, Liewen ; Gu, Zhitao ; Wei, Yucheng ; Liu, Yongyu ; Zhang, Peng ; Chen, Chun ; Zhou, Xinming ; Liu, Yangchun ; Chen, Keneng ; Ding, Jianyong ; Han, Yongtao ; Li, Yin ; Yu, Zhentao ; Liu, Yuan ; Fu, Jianhua ; Shen, Yi ; Wei, Yucheng ; Li, Yin ; Liang, Guanghui ; Chen, Keneng ; Fu, Hao ; Chen, Hezhong ; Yao, Shihua ; Cui, Youbin ; Xin, Yanzhong ; Zhang, Renquan ; Kang, Ningning ; Tan, Lijie ; Ding, Jianyong ; Wang, Hao ; Chen, Gang ; Wu, Jie ; Chen, Chun ; Zheng, Wei ; Pang, Liewen ; Wang, Fangrui ; Liu, Yangchun ; Lin, Qing ; Liu, Yongyu ; Wu, Yongkai ; Fang, Wentao ; Zhang, Jie ; Shen, Yan ; Wang, Changlu ; Zhu, Lei ; Gu, Zhitao ; Han, Yongtao ; Peng, Lin ; Fu, Jianhua ; Liu, Qianwen ; Yu, Zhentao ; Yue, Jie ; Zhang, Peng ; Chen, Yuan ; Wang, Yun ; Geng, Yingcai ; Zhou, Xinming ; Zhao, Hongguang ; Members of the Chinese Alliance for Research in Thymomas</creatorcontrib><description>To study the incidence and pattern of lymph node metastases in thymic malignancies.
This multicenter prospective observational trial with intentional lymph node dissection was carried out by the Chinese Alliance for Research in Thymomas (ChART). Data on patients with thymic tumors without pretreatment were collected prospectively. Results from this prospective study were then compared with those from a previously reported ChART retrospective study.
Among 275 patients, metastasis was detected in 41 nodes (3.04%) in 15 patients (5.5%). The rate of lymph node metastasis was 2.1% (5/238) in patients with thymomas, 25% (6/24) in those with thymic carcinomas, and 50% (4/8) in those with neuroendocrine tumors (P < .001). The rate of lymph node metastasis in category T1 to T4 tumors was 2.7% (6/222) in T1, 7.7% (1/13) in T2, 18.4% (7/38) in T3, and 50% (1/2) in T4 (P < .001). Nodal involvement was significantly higher compared with the ChART retrospective study (5.5% vs 2.2%; P = .002), although the 2 groups were comparable in terms of tumor stage and histology. Metastasis was found in N1 nodes in 13 patients (86.7%) and in N2 nodes in 8 patients (53.3%); 6 patients (40%) had simultaneous N1/N2 diseases and 6 (40%) had multistation involvement. Based on World Health Organization histological classification and Union for International Cancer Control T category, patients were divided into a low-risk group (1/192; 0.5%) with T1-2 and type A-B2 diseases and a high-risk group (14/83; 16.9%) of category T3 and above or histology B3 and above tumors for nodal metastasis (P < .001). On multivariate analysis, type B3/thymic carcinoma/neuroendocrine tumors, category T3 or above, and N2 dissection predicted a greater likelihood of finding nodal metastasis.
Lymph node involvement in thymic malignancies is more common than previously recognized, especially in tumors with aggressive histology and advanced T category. Intentional lymph node dissection increases the detection of nodal involvement and improves accuracy of staging. In selected high-risk patients, systemic dissection of both N1and N2 nodes should be considered for accurate tumor staging.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2018.04.049</identifier><identifier>PMID: 29778330</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>lymph node dissection ; lymph node metastasis ; surgery ; thymic malignancy</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2018-08, Vol.156 (2), p.824-833.e1</ispartof><rights>2018 The American Association for Thoracic Surgery</rights><rights>Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-594f2a4f7f5500812817dff19125d1db7e8ed243b29338b73e34a7a8f9e351d13</citedby><cites>FETCH-LOGICAL-c404t-594f2a4f7f5500812817dff19125d1db7e8ed243b29338b73e34a7a8f9e351d13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522318310341$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29778330$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fang, Wentao</creatorcontrib><creatorcontrib>Wang, Yun</creatorcontrib><creatorcontrib>Pang, Liewen</creatorcontrib><creatorcontrib>Gu, Zhitao</creatorcontrib><creatorcontrib>Wei, Yucheng</creatorcontrib><creatorcontrib>Liu, Yongyu</creatorcontrib><creatorcontrib>Zhang, Peng</creatorcontrib><creatorcontrib>Chen, Chun</creatorcontrib><creatorcontrib>Zhou, Xinming</creatorcontrib><creatorcontrib>Liu, Yangchun</creatorcontrib><creatorcontrib>Chen, Keneng</creatorcontrib><creatorcontrib>Ding, Jianyong</creatorcontrib><creatorcontrib>Han, Yongtao</creatorcontrib><creatorcontrib>Li, Yin</creatorcontrib><creatorcontrib>Yu, Zhentao</creatorcontrib><creatorcontrib>Liu, Yuan</creatorcontrib><creatorcontrib>Fu, Jianhua</creatorcontrib><creatorcontrib>Shen, Yi</creatorcontrib><creatorcontrib>Wei, Yucheng</creatorcontrib><creatorcontrib>Li, Yin</creatorcontrib><creatorcontrib>Liang, Guanghui</creatorcontrib><creatorcontrib>Chen, Keneng</creatorcontrib><creatorcontrib>Fu, Hao</creatorcontrib><creatorcontrib>Chen, Hezhong</creatorcontrib><creatorcontrib>Yao, Shihua</creatorcontrib><creatorcontrib>Cui, Youbin</creatorcontrib><creatorcontrib>Xin, Yanzhong</creatorcontrib><creatorcontrib>Zhang, Renquan</creatorcontrib><creatorcontrib>Kang, Ningning</creatorcontrib><creatorcontrib>Tan, Lijie</creatorcontrib><creatorcontrib>Ding, Jianyong</creatorcontrib><creatorcontrib>Wang, Hao</creatorcontrib><creatorcontrib>Chen, Gang</creatorcontrib><creatorcontrib>Wu, Jie</creatorcontrib><creatorcontrib>Chen, Chun</creatorcontrib><creatorcontrib>Zheng, Wei</creatorcontrib><creatorcontrib>Pang, Liewen</creatorcontrib><creatorcontrib>Wang, Fangrui</creatorcontrib><creatorcontrib>Liu, Yangchun</creatorcontrib><creatorcontrib>Lin, Qing</creatorcontrib><creatorcontrib>Liu, Yongyu</creatorcontrib><creatorcontrib>Wu, Yongkai</creatorcontrib><creatorcontrib>Fang, Wentao</creatorcontrib><creatorcontrib>Zhang, Jie</creatorcontrib><creatorcontrib>Shen, Yan</creatorcontrib><creatorcontrib>Wang, Changlu</creatorcontrib><creatorcontrib>Zhu, Lei</creatorcontrib><creatorcontrib>Gu, Zhitao</creatorcontrib><creatorcontrib>Han, Yongtao</creatorcontrib><creatorcontrib>Peng, Lin</creatorcontrib><creatorcontrib>Fu, Jianhua</creatorcontrib><creatorcontrib>Liu, Qianwen</creatorcontrib><creatorcontrib>Yu, Zhentao</creatorcontrib><creatorcontrib>Yue, Jie</creatorcontrib><creatorcontrib>Zhang, Peng</creatorcontrib><creatorcontrib>Chen, Yuan</creatorcontrib><creatorcontrib>Wang, Yun</creatorcontrib><creatorcontrib>Geng, Yingcai</creatorcontrib><creatorcontrib>Zhou, Xinming</creatorcontrib><creatorcontrib>Zhao, Hongguang</creatorcontrib><creatorcontrib>Members of the Chinese Alliance for Research in Thymomas</creatorcontrib><title>Lymph node metastasis in thymic malignancies: A Chinese multicenter prospective observational study</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>To study the incidence and pattern of lymph node metastases in thymic malignancies.
This multicenter prospective observational trial with intentional lymph node dissection was carried out by the Chinese Alliance for Research in Thymomas (ChART). Data on patients with thymic tumors without pretreatment were collected prospectively. Results from this prospective study were then compared with those from a previously reported ChART retrospective study.
Among 275 patients, metastasis was detected in 41 nodes (3.04%) in 15 patients (5.5%). The rate of lymph node metastasis was 2.1% (5/238) in patients with thymomas, 25% (6/24) in those with thymic carcinomas, and 50% (4/8) in those with neuroendocrine tumors (P < .001). The rate of lymph node metastasis in category T1 to T4 tumors was 2.7% (6/222) in T1, 7.7% (1/13) in T2, 18.4% (7/38) in T3, and 50% (1/2) in T4 (P < .001). Nodal involvement was significantly higher compared with the ChART retrospective study (5.5% vs 2.2%; P = .002), although the 2 groups were comparable in terms of tumor stage and histology. Metastasis was found in N1 nodes in 13 patients (86.7%) and in N2 nodes in 8 patients (53.3%); 6 patients (40%) had simultaneous N1/N2 diseases and 6 (40%) had multistation involvement. Based on World Health Organization histological classification and Union for International Cancer Control T category, patients were divided into a low-risk group (1/192; 0.5%) with T1-2 and type A-B2 diseases and a high-risk group (14/83; 16.9%) of category T3 and above or histology B3 and above tumors for nodal metastasis (P < .001). On multivariate analysis, type B3/thymic carcinoma/neuroendocrine tumors, category T3 or above, and N2 dissection predicted a greater likelihood of finding nodal metastasis.
Lymph node involvement in thymic malignancies is more common than previously recognized, especially in tumors with aggressive histology and advanced T category. Intentional lymph node dissection increases the detection of nodal involvement and improves accuracy of staging. In selected high-risk patients, systemic dissection of both N1and N2 nodes should be considered for accurate tumor staging.</description><subject>lymph node dissection</subject><subject>lymph node metastasis</subject><subject>surgery</subject><subject>thymic malignancy</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kEtrGzEURkVpaNy0v6BQtOxmnKvHRKNAF8G0TcCQTQLZCY10J5aZ0TgjjcH_PnKcdln44G7OfR1CvjFYMmBXl9vlNrt9WnJgzRJkif5AFgy0qq6a-ukjWQBwXtWci3PyOaUtAChg-hM551qpRghYELc-DLsNjaNHOmC2qSQkGiLNm8MQHB1sH56jjS5guqY3dLUJEVOB5z4HhzHjRHfTmHboctgjHduE097mMEbb05Rnf_hCzjrbJ_z6Xi_I4-9fD6vban3_5251s66cBJmrWsuOW9mprq4BGsYbpnzXMc147ZlvFTbouRQt10I0rRIopFW26TSKmnkmLsiP09xyz8uMKZshJId9byOOczIcZHEhdH1ExQl15fQ0YWd2UxjsdDAMzNGu2Zo3u-Zo14As0aXr-_uCuR3Q_-v5q7MAP08Aljf3ASeTirfo0Iep-DF-DP9d8ApZbY3e</recordid><startdate>201808</startdate><enddate>201808</enddate><creator>Fang, Wentao</creator><creator>Wang, Yun</creator><creator>Pang, Liewen</creator><creator>Gu, Zhitao</creator><creator>Wei, Yucheng</creator><creator>Liu, Yongyu</creator><creator>Zhang, Peng</creator><creator>Chen, Chun</creator><creator>Zhou, Xinming</creator><creator>Liu, Yangchun</creator><creator>Chen, Keneng</creator><creator>Ding, Jianyong</creator><creator>Han, Yongtao</creator><creator>Li, Yin</creator><creator>Yu, Zhentao</creator><creator>Liu, Yuan</creator><creator>Fu, Jianhua</creator><creator>Shen, Yi</creator><creator>Wei, Yucheng</creator><creator>Li, Yin</creator><creator>Liang, Guanghui</creator><creator>Chen, Keneng</creator><creator>Fu, Hao</creator><creator>Chen, Hezhong</creator><creator>Yao, Shihua</creator><creator>Cui, Youbin</creator><creator>Xin, Yanzhong</creator><creator>Zhang, Renquan</creator><creator>Kang, Ningning</creator><creator>Tan, Lijie</creator><creator>Ding, Jianyong</creator><creator>Wang, Hao</creator><creator>Chen, Gang</creator><creator>Wu, Jie</creator><creator>Chen, Chun</creator><creator>Zheng, Wei</creator><creator>Pang, Liewen</creator><creator>Wang, Fangrui</creator><creator>Liu, Yangchun</creator><creator>Lin, Qing</creator><creator>Liu, Yongyu</creator><creator>Wu, Yongkai</creator><creator>Fang, Wentao</creator><creator>Zhang, Jie</creator><creator>Shen, Yan</creator><creator>Wang, Changlu</creator><creator>Zhu, Lei</creator><creator>Gu, Zhitao</creator><creator>Han, Yongtao</creator><creator>Peng, Lin</creator><creator>Fu, Jianhua</creator><creator>Liu, Qianwen</creator><creator>Yu, Zhentao</creator><creator>Yue, Jie</creator><creator>Zhang, Peng</creator><creator>Chen, Yuan</creator><creator>Wang, Yun</creator><creator>Geng, Yingcai</creator><creator>Zhou, Xinming</creator><creator>Zhao, Hongguang</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201808</creationdate><title>Lymph node metastasis in thymic malignancies: A Chinese multicenter prospective observational study</title><author>Fang, Wentao ; Wang, Yun ; Pang, Liewen ; Gu, Zhitao ; Wei, Yucheng ; Liu, Yongyu ; Zhang, Peng ; Chen, Chun ; Zhou, Xinming ; Liu, Yangchun ; Chen, Keneng ; Ding, Jianyong ; Han, Yongtao ; Li, Yin ; Yu, Zhentao ; Liu, Yuan ; Fu, Jianhua ; Shen, Yi ; Wei, Yucheng ; Li, Yin ; Liang, Guanghui ; Chen, Keneng ; Fu, Hao ; Chen, Hezhong ; Yao, Shihua ; Cui, Youbin ; Xin, Yanzhong ; Zhang, Renquan ; Kang, Ningning ; Tan, Lijie ; Ding, Jianyong ; Wang, Hao ; Chen, Gang ; Wu, Jie ; Chen, Chun ; Zheng, Wei ; Pang, Liewen ; Wang, Fangrui ; Liu, Yangchun ; Lin, Qing ; Liu, Yongyu ; Wu, Yongkai ; Fang, Wentao ; Zhang, Jie ; Shen, Yan ; Wang, Changlu ; Zhu, Lei ; Gu, Zhitao ; Han, Yongtao ; Peng, Lin ; Fu, Jianhua ; Liu, Qianwen ; Yu, Zhentao ; Yue, Jie ; Zhang, Peng ; Chen, Yuan ; Wang, Yun ; Geng, Yingcai ; Zhou, Xinming ; Zhao, Hongguang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-594f2a4f7f5500812817dff19125d1db7e8ed243b29338b73e34a7a8f9e351d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>lymph node dissection</topic><topic>lymph node metastasis</topic><topic>surgery</topic><topic>thymic malignancy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fang, Wentao</creatorcontrib><creatorcontrib>Wang, Yun</creatorcontrib><creatorcontrib>Pang, Liewen</creatorcontrib><creatorcontrib>Gu, Zhitao</creatorcontrib><creatorcontrib>Wei, Yucheng</creatorcontrib><creatorcontrib>Liu, Yongyu</creatorcontrib><creatorcontrib>Zhang, Peng</creatorcontrib><creatorcontrib>Chen, Chun</creatorcontrib><creatorcontrib>Zhou, Xinming</creatorcontrib><creatorcontrib>Liu, Yangchun</creatorcontrib><creatorcontrib>Chen, Keneng</creatorcontrib><creatorcontrib>Ding, Jianyong</creatorcontrib><creatorcontrib>Han, Yongtao</creatorcontrib><creatorcontrib>Li, Yin</creatorcontrib><creatorcontrib>Yu, Zhentao</creatorcontrib><creatorcontrib>Liu, Yuan</creatorcontrib><creatorcontrib>Fu, Jianhua</creatorcontrib><creatorcontrib>Shen, Yi</creatorcontrib><creatorcontrib>Wei, Yucheng</creatorcontrib><creatorcontrib>Li, Yin</creatorcontrib><creatorcontrib>Liang, Guanghui</creatorcontrib><creatorcontrib>Chen, Keneng</creatorcontrib><creatorcontrib>Fu, Hao</creatorcontrib><creatorcontrib>Chen, Hezhong</creatorcontrib><creatorcontrib>Yao, Shihua</creatorcontrib><creatorcontrib>Cui, Youbin</creatorcontrib><creatorcontrib>Xin, Yanzhong</creatorcontrib><creatorcontrib>Zhang, Renquan</creatorcontrib><creatorcontrib>Kang, Ningning</creatorcontrib><creatorcontrib>Tan, Lijie</creatorcontrib><creatorcontrib>Ding, Jianyong</creatorcontrib><creatorcontrib>Wang, Hao</creatorcontrib><creatorcontrib>Chen, Gang</creatorcontrib><creatorcontrib>Wu, Jie</creatorcontrib><creatorcontrib>Chen, Chun</creatorcontrib><creatorcontrib>Zheng, Wei</creatorcontrib><creatorcontrib>Pang, Liewen</creatorcontrib><creatorcontrib>Wang, Fangrui</creatorcontrib><creatorcontrib>Liu, Yangchun</creatorcontrib><creatorcontrib>Lin, Qing</creatorcontrib><creatorcontrib>Liu, Yongyu</creatorcontrib><creatorcontrib>Wu, Yongkai</creatorcontrib><creatorcontrib>Fang, Wentao</creatorcontrib><creatorcontrib>Zhang, Jie</creatorcontrib><creatorcontrib>Shen, Yan</creatorcontrib><creatorcontrib>Wang, Changlu</creatorcontrib><creatorcontrib>Zhu, Lei</creatorcontrib><creatorcontrib>Gu, Zhitao</creatorcontrib><creatorcontrib>Han, Yongtao</creatorcontrib><creatorcontrib>Peng, Lin</creatorcontrib><creatorcontrib>Fu, Jianhua</creatorcontrib><creatorcontrib>Liu, Qianwen</creatorcontrib><creatorcontrib>Yu, Zhentao</creatorcontrib><creatorcontrib>Yue, Jie</creatorcontrib><creatorcontrib>Zhang, Peng</creatorcontrib><creatorcontrib>Chen, Yuan</creatorcontrib><creatorcontrib>Wang, Yun</creatorcontrib><creatorcontrib>Geng, Yingcai</creatorcontrib><creatorcontrib>Zhou, Xinming</creatorcontrib><creatorcontrib>Zhao, Hongguang</creatorcontrib><creatorcontrib>Members of the Chinese Alliance for Research in Thymomas</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fang, Wentao</au><au>Wang, Yun</au><au>Pang, Liewen</au><au>Gu, Zhitao</au><au>Wei, Yucheng</au><au>Liu, Yongyu</au><au>Zhang, Peng</au><au>Chen, Chun</au><au>Zhou, Xinming</au><au>Liu, Yangchun</au><au>Chen, Keneng</au><au>Ding, Jianyong</au><au>Han, Yongtao</au><au>Li, Yin</au><au>Yu, Zhentao</au><au>Liu, Yuan</au><au>Fu, Jianhua</au><au>Shen, Yi</au><au>Wei, Yucheng</au><au>Li, Yin</au><au>Liang, Guanghui</au><au>Chen, Keneng</au><au>Fu, Hao</au><au>Chen, Hezhong</au><au>Yao, Shihua</au><au>Cui, Youbin</au><au>Xin, Yanzhong</au><au>Zhang, Renquan</au><au>Kang, Ningning</au><au>Tan, Lijie</au><au>Ding, Jianyong</au><au>Wang, Hao</au><au>Chen, Gang</au><au>Wu, Jie</au><au>Chen, Chun</au><au>Zheng, Wei</au><au>Pang, Liewen</au><au>Wang, Fangrui</au><au>Liu, Yangchun</au><au>Lin, Qing</au><au>Liu, Yongyu</au><au>Wu, Yongkai</au><au>Fang, Wentao</au><au>Zhang, Jie</au><au>Shen, Yan</au><au>Wang, Changlu</au><au>Zhu, Lei</au><au>Gu, Zhitao</au><au>Han, Yongtao</au><au>Peng, Lin</au><au>Fu, Jianhua</au><au>Liu, Qianwen</au><au>Yu, Zhentao</au><au>Yue, Jie</au><au>Zhang, Peng</au><au>Chen, Yuan</au><au>Wang, Yun</au><au>Geng, Yingcai</au><au>Zhou, Xinming</au><au>Zhao, Hongguang</au><aucorp>Members of the Chinese Alliance for Research in Thymomas</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lymph node metastasis in thymic malignancies: A Chinese multicenter prospective observational study</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2018-08</date><risdate>2018</risdate><volume>156</volume><issue>2</issue><spage>824</spage><epage>833.e1</epage><pages>824-833.e1</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>To study the incidence and pattern of lymph node metastases in thymic malignancies.
This multicenter prospective observational trial with intentional lymph node dissection was carried out by the Chinese Alliance for Research in Thymomas (ChART). Data on patients with thymic tumors without pretreatment were collected prospectively. Results from this prospective study were then compared with those from a previously reported ChART retrospective study.
Among 275 patients, metastasis was detected in 41 nodes (3.04%) in 15 patients (5.5%). The rate of lymph node metastasis was 2.1% (5/238) in patients with thymomas, 25% (6/24) in those with thymic carcinomas, and 50% (4/8) in those with neuroendocrine tumors (P < .001). The rate of lymph node metastasis in category T1 to T4 tumors was 2.7% (6/222) in T1, 7.7% (1/13) in T2, 18.4% (7/38) in T3, and 50% (1/2) in T4 (P < .001). Nodal involvement was significantly higher compared with the ChART retrospective study (5.5% vs 2.2%; P = .002), although the 2 groups were comparable in terms of tumor stage and histology. Metastasis was found in N1 nodes in 13 patients (86.7%) and in N2 nodes in 8 patients (53.3%); 6 patients (40%) had simultaneous N1/N2 diseases and 6 (40%) had multistation involvement. Based on World Health Organization histological classification and Union for International Cancer Control T category, patients were divided into a low-risk group (1/192; 0.5%) with T1-2 and type A-B2 diseases and a high-risk group (14/83; 16.9%) of category T3 and above or histology B3 and above tumors for nodal metastasis (P < .001). On multivariate analysis, type B3/thymic carcinoma/neuroendocrine tumors, category T3 or above, and N2 dissection predicted a greater likelihood of finding nodal metastasis.
Lymph node involvement in thymic malignancies is more common than previously recognized, especially in tumors with aggressive histology and advanced T category. Intentional lymph node dissection increases the detection of nodal involvement and improves accuracy of staging. In selected high-risk patients, systemic dissection of both N1and N2 nodes should be considered for accurate tumor staging.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29778330</pmid><doi>10.1016/j.jtcvs.2018.04.049</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-5223 |
| ispartof | The Journal of thoracic and cardiovascular surgery, 2018-08, Vol.156 (2), p.824-833.e1 |
| issn | 0022-5223 1097-685X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2042233951 |
| source | Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | lymph node dissection lymph node metastasis surgery thymic malignancy |
| title | Lymph node metastasis in thymic malignancies: A Chinese multicenter prospective observational study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T02%3A19%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Lymph%20node%20metastasis%20in%20thymic%20malignancies:%20A%20Chinese%20multicenter%20prospective%20observational%20study&rft.jtitle=The%20Journal%20of%20thoracic%20and%20cardiovascular%20surgery&rft.au=Fang,%20Wentao&rft.aucorp=Members%20of%20the%20Chinese%20Alliance%20for%20Research%20in%20Thymomas&rft.date=2018-08&rft.volume=156&rft.issue=2&rft.spage=824&rft.epage=833.e1&rft.pages=824-833.e1&rft.issn=0022-5223&rft.eissn=1097-685X&rft_id=info:doi/10.1016/j.jtcvs.2018.04.049&rft_dat=%3Cproquest_cross%3E2042233951%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2042233951&rft_id=info:pmid/29778330&rft_els_id=S0022522318310341&rfr_iscdi=true |