Clinical and pathologic predictors of outcome in Thymoma-Associated myasthenia gravis

López‐Cano, Manuel; Ponseti-Bosch, José M; Espín‐Basany, Eloy; Sánchez-García, José Luis; Armengol, Manel

doi:10.1016/s0003-4975(03)01139-1

Cited by 76 publications

(51 citation statements)

References 25 publications

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“…Previously, findings showed that younger patients have a better outcome after thymectomy [10,16,39]. In accordance with these data, younger patients had a longer survival rate and better quality of life after thymectomy in our trial.…”

Section: Discussionsupporting

confidence: 91%

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Long-term outcome and quality of life after open and thoracoscopic thymectomy for myasthenia gravis: analysis of 131 patients

et al. 2008

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Transsternal and minimally invasive thymectomy contribute to an improvement in myasthenia gravis symptoms for all subgroups. Surgery can be performed with low individual risks. In our trial, minimally invasive surgery was found to be superior in terms of improvement in myasthenia gravis-associated symptoms. Additionally, the hospital stay was shorter, and the patients felt less disturbed by direct effects of the operation. Therefore, minimally invasive thymectomy can be regarded as the treatment of choice for patients undergoing surgery for myasthenia gravis.

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Section: Discussionsupporting

confidence: 91%

“…Myasthenia-associated complications are shown to occur for 40% of the patients [16] and postoperative complications for 27.5% to 70% [16,21]. These results are comparable with our findings of 31% and 19.8%, respectively, with no significant differences found between the two surgical approaches.…”

Section: Discussionsupporting

confidence: 88%

Long-term outcome and quality of life after open and thoracoscopic thymectomy for myasthenia gravis: analysis of 131 patients

et al. 2008

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“…MG occurs in 15-60% of patients with thymoma, according to various studies (24)(25)(26). In the present results, thymoma patients with MG accounted for 36.5% of the patients.…”

Section: Discussionsupporting

confidence: 70%

Myasthenia gravis in patients with thymoma affects survival rate following extended thymectomy

et al. 2016

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Abstract. Thymomas are the most common adult tumors in the anterior mediastinal compartment, and a significant amount of thymomas are complicated by myasthenia gravis (MG). Extended thymectomy (ET) is the primary treatment method for thymomas and is used to completely resect possible ectopic thymus to avoid recurrence. Studies on the effect of MG in thymoma patients following ET are limited. The aim of the present study was to determine whether the presence of MG affects the prognosis of patients with thymoma. The present study consisted of 104 patients with thymoma that underwent ET; 61 men (58.7%) and 43 women (41.3%) (mean age, 54.6 years). In total, 38 patients had MG (36.5%). MG was most frequently observed in World Health Organization (WHO) classification type B2 thymoma compared with other types of thymoma. During the 5-year follow-up period, 11 patients succumbed to a recurrence of thymoma or respiratory failure due to MG. The overall 5-year survival rate in patients without MG or with MG was 89.1 and 76.0%, respectively. The overall survival (OS) rate in patients with Masaoka stages I + II and III + IV was 90.0 and 68.0%, respectively. The OS rate in patients with WHO type A + AB + B1 and type B2 + B3 was 96.9 and 76.8%, respectively. The patients with MG (P=0.026), Masaoka stages III + IV (P= 0.008) and WHO type B2 + B3 (P=0.032) had a poorer prognosis compared with patients without these characteristics. Furthermore, multivariate analysis by Cox regression revealed that age [P=0.032; relative risk (RR)=1.097; 95% confidence interval (CI)=1. 097-1.192] and MG (P= 0.042; RR= 0.167; 95% CI= 0.037-0.940) significantly affected OS rate. In summary, ET is a reliable method for the treatment of thymoma. Long-term survival is expected for patients at early Masaoka stages, and for patients without MG. The prognosis of patients with thymomas with MG is poorer compared with patients without MG. The present findings provide useful information for the future management of patients with thymomas. IntroductionThymoma is a tumor originating from the epithelial cells of the thymus and is a relatively rare neoplasm with an incidence of 0.13 cases per 100,000 individuals per year (1,2). The prognosis of patients with thymoma largely depends on the Masaoka stage of disease and prognosis is poorer for patients with stage III or IV compared with patients with stage I and II tumors (3). The 10-year survival rates are 90, 70, 55 and 35% for stages I, II, III, and IV thymoma, respectively (4). Surgical resection is the primary treatment method for thymoma and a sternotomy is the optimal surgical procedure for thymoma, since it may not be possible to perform a complete thymectomy via thoracotomy on locally advanced lesions, particularly those that are stage III-IV (5,6). Normally, thymoma is a slow-growing tumor, but 40% of thymomas exhibit a locally invasive growth pattern. In addition, thymomas often result in the development of pleural dissemination and distant metastasis (7,8). Therefore, complete resection should be th...

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“…14 The relationship between thymoma and MG was first identified by Weigert in 1901, and thymoma is pointed out to be a negative prognostic factor of the outcome for MG. 15 A study further reports that T-MG occurs in~80~85% of MG patients with Abbreviations: anti-AchR, acetylcholine receptor antibody; NT-MG, nonthymoma-associated myasthenia gravis; T-MG, thymoma-associated myasthenia gravis; TNF-α, tumor necrosis factor-alpha. a P o0.05 compared with the frequency of the TT genotype in the NT-MG group.…”

Section: Discussionmentioning

confidence: 99%

Correlations of TNF-α gene promoter polymorphisms with the risk of thymoma-associated myasthenia gravis in a northern Chinese Han population

Lei

Xie

et al. 2017

Cancer Gene Ther

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This study was performed with the aim to investigate the correlations of tumor necrosis factor-alpha (TNF-α) gene promoter polymorphisms with the risk of thymoma-associated myasthenia gravis (T-MG) in a northern Chinese Han population. Between June 2005 and June 2015, 305 MG patients (150 males and 155 females, MG group) and 293 healthy volunteers (negative control (NC) group) were enrolled in this study. Among the MG patients, there were 121 patients with thymoma-associated MG (T-MG group) and 184 without T-MG (NT-MG group). Enzyme-linked immunosorbent assay (ELISA) was used for the serum TNF-α level. Polymerase chain reaction-restriction fragment length polymorphism was conducted to determine genotype and allele frequencies of TNF-α gene promoter -1031T/C, -857C/T and -863C/A. The haplotype was analyzed with the SHEsis software. Logistic regression analysis was performed for correlations between TNF-α gene promoter polymorphisms and the risk of T-MG. The T-MG group had higher frequencies of the CT/TT genotype and T allele of -857C/T than the NT-MG and NC groups. The frequencies of the CC genotype and C allele of -1031T/C were higher in the T-MG group than in the NT-MG and NC groups, and higher in male patients in the T-MG group than in male patients in the NC group. TTA and TTC haplotypes exhibited lower frequencies in the T-MG group than in the NT-MG group. The ocular MG patients exhibited lower frequencies of the TT genotype and T allele of -857C/T than the generalized MG patients did. The TNF-α level was elevated in the T-MG group compared with that in the NC and NT-MG groups, indicating that the TC+CC and CT+TT genotypes were increased compared with the TT and CC genotypes in the -1031T/C and -857C/T, respectively. Logistic regression analysis suggested that expressions of anti-acetylcholine receptor antibodies, Osserman's classification, -1031T/C and -857C/T polymorphisms and the TTA haplotype were the independent risk factors for T-MG. These findings reveal that TNF-α -1031T/C and -857C/T polymorphisms and the TTA haplotype may be correlated with the occurrence of T-MG in a Northern Chinese Han population.

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Clinical and pathologic predictors of outcome in Thymoma-Associated myasthenia gravis

Cited by 76 publications

References 25 publications

Long-term outcome and quality of life after open and thoracoscopic thymectomy for myasthenia gravis: analysis of 131 patients

Long-term outcome and quality of life after open and thoracoscopic thymectomy for myasthenia gravis: analysis of 131 patients

Myasthenia gravis in patients with thymoma affects survival rate following extended thymectomy

Correlations of TNF-α gene promoter polymorphisms with the risk of thymoma-associated myasthenia gravis in a northern Chinese Han population

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