La myasthénie associée aux thymomes : particularités cliniques et résultats chirurgicaux

Abstract

ObjectiveThe aim of this study was to compare the characteristics of myasthenic patients with and without thymoma, and the results of thymectomy in both types of patients. Material and methodsA retrospective study was conducted among 66 patients who underwent thymectomy for myasthenia gravis in our department over a 10-year period (2000–2010). The surgical approach was sternotomy or anterolateral thoracotomy. Patients were divided into two groups according to the presence of thymoma: with (T-MG) and without (NT-MG) thymoma. Complete stable remission (CSR) was the primary endpoint. ResultsMedian age was 35.09±9.89years. The NT-MG group had 38 patients (57.57%) and the T-MG group 28 patients (42.43%). There was no difference between the two groups regarding the surgical approach (P=0.52). T-MG patients were older (40.54±15.16 vs. 31.37±9.46) (P=0.008) and predominantly male. There were more generalized forms (P=0.01) and more bulbar involvement (P=0.02) in the T-MG group. The rate of CSR at 5years was 7% and 17% in the T-MG and NT-MG patients respectively (P=0.70). At 10years, it was 36% and 94.73% respectively (P=0.03). ConclusionThymomatous myasthenia gravis is characterized by the severity of its clinical features. Remission rate at 10years was significantly lower in the myasthenia with thymoma group.