目的：关于术后复发性胸腺癌（TC）和胸腺神经内分泌癌（TNEC）的预后数据很少。这项研究的目的是评估接受手术切除后复发性TC和TNEC患者的治疗和生存率。
方法：使用我们的多中心数据库进行回顾性图表审查，以确定1995年至2018年TC和TNEC术后复发的患者。对其临床病理因素进行回顾性分析，并对生存结局进行分析。
结果：在152例接受TC和TNEC切除术的患者中，发现60例患者。从首次复发开始的中位随访期为14.8个月（范围0-144）。整个队列的5年复发后生存率为23%。根据单变量分析，晚期[危险比（HR）2.81，95%置信区间（CI）1.09-9.54]，初次手术与复发之间的间隔（HR0.97，95％CI0.95-0.99），复发的任何治疗(HR:0.27,95%CI0.13-0.58)和复发的化疗(HR:0.46,95%CI0.22-0.95)是与复发后生存相关的显著因素.
结论：化疗而不是手术似乎是治疗术后复发TC和TNEC患者的主要治疗方法，也可以在多学科管理中考虑。需要更大样本量的进一步研究来证实我们的发现。
OBJECTIVE: There are few data available on the outcomes of postoperative recurrent thymic carcinoma (TC) and thymic neuroendocrine carcinoma (TNEC). The aim of this
study is to evaluate the treatment and survival in patients with recurrent TC and TNEC after undergoing surgical resection.
METHODS: A retrospective chart review was performed using our multicenter database to identify patients with a postoperative recurrence of TC and TNEC from 1995 to 2018. The clinicopathological factors were reviewed and the survival outcomes were analyzed.
RESULTS: Sixty patients were identified among 152 patients who underwent resection of TC and TNEC. The median follow-up period from the first recurrence was 14.8 months (range 0-144). The 5-year post-recurrence survival was 23% for the whole cohort. According to a univariable analysis, advanced stage [hazard ratio (HR) 2.81, 95% confidence interval (CI) 1.09-9.54], interval between primary surgery and recurrence (HR 0.97, 95% CI 0.95-0.99), any treatment for recurrence (HR: 0.27, 95% CI 0.13-0.58) and chemotherapy for recurrence (HR: 0.46, 95% CI 0.22-0.95) were significant factors related to post-recurrence survival.
CONCLUSIONS: Chemotherapy rather than surgery appears to be the mainstay treatment for managing patients with postoperative recurrent TC and TNEC and it may also be considered in multidisciplinary management. Further studies with a larger sample size are required to confirm our findings.
