Abstract
IntroductionTo evaluate the different pathological and clinical characters of thymoma with and without myasthenia gravis (MG) and to determine whether the presence of MG influences the prognosis in patients with thymoma.MethodsFour hundred and twenty-five consecutive patients operated was analyzed. A median sternotomy was used in 189 cases, and video-assisted thoracoscopic thymectomy was used in 236 cases. These patients with thymoma were subdivided into two groups: thymoma with myasthenia gravis MG (n = 220) and thymoma without MG (n = 205). All thymic epithelial tumors were classified according to the WHO histologic classification and the Masaoka clinical staging system. The result was evaluated according to the Myasthenia Gravis Foundation of America's criterion. The clinical features of the 2 test were compared between the two groups, and the survival analysis of Cox treatment effects was compared between the two groups.ResultsThere were no perioperative deaths. The proportions of type A and thymic carcinoma were 0% in the group with MG and 10.7% (22/205) and 11.2% (23/205), respectively, in the group without MG. Thymic hyperplasia around the thymoma was 29.1% (64/220) in patients with MG and only 6.3% (13/205) in patients without MG (χ2 = 23.63, P = 0.000). The overall survival curve showed that the 5- and 10-year survival rates in the group without MG were 89.2 and 77.4%, respectively, while those in the MG group were 91.1 and 80.5%.ConclusionsThe existence of MG has little influence on the prognosis of thymomas, but it is suitable for early diagnosis and treatment. Extended thymectomy should be performed on all patients with thymoma, whether they have MG or not.
Highlights
To evaluate the different pathological and clinical characters of thymoma with and without myasthenia gravis (MG) and to determine whether the presence of MG influences the prognosis in patients with thymoma
The MG group was divided into 74 cases of type I, 43 cases of type IIa, 47 cases of type IIb, cases of type IIIa, cases of type IIIb, four cases of type IVa and three cases of type IVb according to the clinical classification of the American Myasthenia Gravis Foundation of America (MGFA) [3, 4]
In the MG group, a small thymoma was found in seven cases around the tumor, with a maximum diameter of 2–5 mm
Summary
To evaluate the different pathological and clinical characters of thymoma with and without myasthenia gravis (MG) and to determine whether the presence of MG influences the prognosis in patients with thymoma. Thymoma is often accompanied by paraneoplastic syndromes, such as hyperthyroidism, pure erythrocyte aplasia anemia, MG, and endocrinopathy. Domestic and foreign data show that the proportion of MG combined with thymoma is 11.2–29.8%, while the proportion of thymoma combined with MG is 14.9–60.3%. There are differences in clinicopathological characters between thymoma combined with MG and thymoma alone. Academic circles have had disagreements about their outcome [1, 2]. We retrospectively analyzed 425 patients with thymoma who underwent surgery in our hospital from January 2003 to December 2010 and discussed their clinical characteristics
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