Predictors of Outcome for Myasthenia Gravis after Thymectomy

Abstract

The aim of this study was to assess the clinical outcome of patients with myasthenia gravis treated with maximal thymectomy and to identify prognostic variables that predict the outcome. Over 15 years, from 1986 to 2001, we collected data on 100 patients with myasthenia gravis who underwent maximal thymectomy and retrospectively reviewed their outcome. Women comprised 63% and the median age was 25 years (range, 4 to 61). The median duration of the disease was 26 months (range, 1 to 240). According to the Osserman classification, there were seven patients in class I, 31 in class II, 47 in class III, and 15 in class IV. In non thymomatous patients (93 patients), complete remission rate progressively increased from 37.4% to 58.2% and 75% at 3, 10 and 15 years of follow-up respectively. These findings suggest that the complete remission rate is prone to increase with time after maximal thymectomy. The total benefit rate achieved was estimated to be 86% while 14% did not improve at a mean follow-up period of 7.6 years (range, 8 to 180 months). Univariate analysis (p < 0.05) showed that age, thymic histology and ectopic thymic tissue are significant prognostic factors for outcome.

Eight-year follow-up of patients with myasthenia gravis after thymectomy

“…Our data did not disclose that onset age was a significant factor associated with CSR and clinical remission in patients with MG (Table ), inconsistent with previous results . At the same time, our results showed that gender did not affect the long‐term outcome, similar with other researches .…”

“…The 8‐year follow‐up study showed that the overall clinical remission rate (57.9%) and improvement rate (81.1%) were comparable to other large studies (Table ). However, the CSR rate (27.3%) was lower than other reported studies (Table ), probably due to the larger portion of late onset patients (34%) in this group, especially the ones with thymoma, in contrast to patients in other study (8.1%) . As there are no issued guidelines for withdrawing drug therapy from patients with MG, the physicians in our team take appropriate cautions when discontinuing drugs after patients gain clinical remission, in an attempt to avoid symptomatic relapse.…”

Uncommon Thoracic Tumors

“…62,133,139 Older series reported a poor prognosis associated with myasthenia gravis, 6,49,50 but several modern series have failed to confirm this observation. [145][146][147] About 50% of patients with pure red cell aplasia have thymoma, and about 10% of patients with hypogammaglobulinemia have thymoma. 136,143,144 After thymectomy, patients with myasthenia gravis have attenuation of the severity of symptoms over time but not necessarily complete resolution of them.…”

Vaikų priekinio tarpuplaučio navikų ir displazijų chirurginis

“…[3,15]. Diskutuojama dël navikø ávairovës ir dël jø klasifikacijos [16][17][18][19][20], dël uþkrûèio liaukos hiperplazijos, jos ryðio su myasthenia gravis ir chirurginio gydymo [21][22][23][24][25][26].…”