Abstract:
INTRODUCTION:Thymectomy is required for the treatment of thymoma-associated myasthenia gravis (MG). However, MG may develop only after thymectomy, a condition known as post-thymectomy MG. This study aimed to investigate the risk factors for post-thymectomy MG in patients with thymoma. METHODS:We retrospectively identified 235 patients with thymoma who underwent thymectomy at a single hospital from January 2008 to December 2017. Forty-four with preoperatively diagnosed MG were excluded, leaving 191 patients in the final analysis. Univariable survival analyses using Cox proportional hazards regression model and Kaplan-Meier estimate were conducted to identify risk factors for post-thymectomy MG. RESULTS:Post-thymectomy MG developed in 4.2% (8/191) of the patients with thymoma between 18 days and 108 months after surgery. Hazard ratios (HR) of pre- and postoperative anti-acetylcholine receptor antibody (AchR-Ab) titers were 2.267 (p = 0.002) and 1.506 (p < 0.001), respectively. Patients with extended thymectomy had a low chance of post-thymectomy MG (HR 0.035, p = 0.007). Larger thymoma (HR 1.359, p = 0.005) and type A or AB thymoma according to World Health Organization histological classification (HR 11.92, p = 0.021) were associated with higher chances of post-thymectomy MG. Within the subgroup of preoperatively AchR-Ab seropositive patients, post-thymectomy MG developed in 22.2% (6/27). DISCUSSION:Pre- and postoperative AchR-Ab levels should be measured in patients with thymoma. A large thymoma and partial thymectomy appear to be associated with a higher probability of post-thymectomy MG.
journal_name
Muscle Nervejournal_title
Muscle & nerveauthors
Kim A,Choi SJ,Kang CH,Lee S,Son H,Kim JA,Shin JY,Kim SM,Hong YH,Sung JJdoi
10.1002/mus.27169subject
Has Abstractpub_date
2021-01-12 00:00:00eissn
0148-639Xissn
1097-4598pub_type
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