Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan.
Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Hyogo, Japan.
Asian Cardiovasc Thorac Ann. 2022 Oct;30(8):924-930. doi: 10.1177/02184923221116679. Epub 2022 Jul 27.
Myasthenia gravis (MG) is the most common paraneoplastic syndrome in thymoma. However, the association between MG and postoperative outcomes is controversial. Therefore, we examined the effect of MG on the surgical outcomes of patients with thymoma.
This study enrolled 145 consecutive patients with thymoma who underwent surgical resection at our institution between January 2000 and December 2020. The patients were classified into thymoma with MG (MG group) and without MG (non-MG group). Data about characteristics of patients, surgical outcomes, and prognostic factors were compared between the two groups.
Of 145 patients, 47 (32%) presented with MG and 98 (68%) did not. There was no significant difference in terms of the incidence of postoperative complications, overall survival (OS), and recurrence-free survival (RFS) between the two groups. The deaths were not caused by thymoma. Among the patients aged >60 years, the MG group had a lower survival rate than the non-MG group. In the univariate analysis, age ≥60 years was a poor prognostic factor for OS, whereas in the multivariate analysis, Masaoka stage III and IV classifications were poor prognostic factors for RFS.
The incidence of postoperative complications did not differ between patients with thymoma and without MG. In the MG group, age ≥60 years was a poor prognostic factor for OS. The postoperative follow-up of patients aged ≥60 years with thymoma with MG should focus on not only recurrence but also progression of diseases other than thymoma.
重症肌无力（MG）是胸腺瘤最常见的副瘤综合征。然而，MG 与术后结局的相关性存在争议。因此，我们研究了 MG 对胸腺瘤患者手术结局的影响。
本研究纳入了 2000 年 1 月至 2020 年 12 月在我院接受手术切除的 145 例连续胸腺瘤患者。将患者分为伴 MG 的胸腺瘤（MG 组）和不伴 MG 的胸腺瘤（非 MG 组）。比较两组患者的特征、手术结局和预后因素。
145 例患者中，47 例（32%）伴有 MG，98 例（68%）不伴 MG。两组术后并发症发生率、总生存（OS）和无复发生存（RFS）均无显著差异。死亡不是由胸腺瘤引起的。在>60 岁的患者中，MG 组的生存率低于非 MG 组。在单因素分析中，年龄≥60 岁是 OS 的不良预后因素，而在多因素分析中，Masaoka 分期 III 和 IV 是 RFS 的不良预后因素。
伴或不伴 MG 的胸腺瘤患者术后并发症发生率无差异。在 MG 组中，年龄≥60 岁是 OS 的不良预后因素。MG 组中年龄≥60 岁伴胸腺瘤的患者术后随访不仅应关注肿瘤复发，还应关注肿瘤以外疾病的进展。
