Postoperative survival for patients with thymoma complicating myasthenia gravis—preliminary retrospective results of the ChART database

Abstract

Background: It is so far not clear that how myasthenia gravis (MG) affected the prognosis of thymoma patients. The aim of this assay is to compare the postoperative survival between patients with thymoma only and those with both thymoma and MG. Methods:The Chinese Alliance for Research in Thymomas (ChART) registry recruited patients with thymoma from 18 centers over the country on an intention to treat basis from 1992 to 2012. Two groups were formed according to whether the patient complicated MG. Demographic and clinical data were reviewed, patients were followed and their survival status were analyzed.Results: There were 1,850 patients included in this study, including 421 with and 1,429 without MG.Complete thymectomy were done in 91.2% patients in MG group and 71.0% in non-MG group (P<0.05).There were more percentage of patients with the histology of thymoma AB, B1, or B2 (P<0.05) in MG group, and more percentage of patients with MG were in Masaoka stage I and II. The 5-and 10-year overall survival (OS) rates were both higher in MG group (93% vs. 88%; 83% vs. 81%, P=0.034) respectively. The survival rate was significantly higher in patients with MG when the Masaoka staging was 3/4 (P=0.003). Among patients with advanced stage thymoma (stage 3, 4a, 4b), the constituent ratios of 3, 4a, 4b were similar between MG and non-MG group. Histologically, however, there were significantly more proportion of AB/B1/B2/B3 in the MG group while there were more C in the non-MG group (P=0.000).

Surgical effect and prognostic factors of myasthenia gravis with thymomas

“…Previous articles have reported that WHO classification, Masaoka stage, and R0 resection status may influence the recurrence and long‐term prognosis of thymomas . COX regression analysis in our study indicated that Masaoka stage III + IV, not‐R0 resection, and recurrence were independent risk prognostic factors, but older age seemed to be a protective factor for recurrence, which was similar to the study by Li .…”

Paraneoplastic Syndromes and Thymic Malignancies: An Examination of the International Thymic Malignancy Interest Group Retrospective Database

“…In the ITMIG cohort, approximately one-third of patients with TETs had a PN/AI syndrome. 29 This is similar to the prevalence of MG reported in national retrospective database studies 29 , including Japanese Association for Research on the Thymus (JART) 30 , European Society of Thoracic Surgeons (ESTS) 31 , and Chinese Alliance for Research in Thymomas (ChART) 32 . There is overlap with these national databases and our ITMIG database cohort, including 31% cases from the ChART database and 14% cases from the ESTS database (Supplementary Data Fig.14), while the JART database was not included.…”

Myasthenia gravis as a prognostic marker in patients with thymoma

“…The prognostic value of MG associated thymoma remains controversial in the different reports of the literature, some established the presence of MG as a good survival prognostic factor related to the onset of MG symptoms that leads a prompt approach and treatment (23)(24)(25); others reported that having MG or not, didn't show any statistical significance, same as our results (11,(26)(27)(28); and finally, some studies reported even a worse prognosis in patients with MG (17,29). This discrepancies are probably due to the wide range of clinical and pathogenic variants in MG patients, the present study has several limitations: the information was retrospectively acquired at a single institution, it includes only 64 patients and a referral bias should be considered, nevertheless, this report is valuable because in the best of our knowledge there is scarce information about MG and thymoma from Hispanic referral cancer centers; a study from 1991 had one of the largest population with MG and thymoma, and they reported a better overall survival in patients with MG compared with TnMG group (30).…”