In patients with myasthenia gravis (MG) and those without the disorder, postsurgical complications following thymoma do not differ, according to the results of a study that was published in Asian Cardiovascular and Thoracic Annals.

The researchers sought to explore the impact of MG among patients with thymoma undergoing surgery. A total of 145 consecutive patients with thymoma who underwent surgical resection at Kobe University Hospital in Hyogo, Japan, between January 2000 and December 2020 were evaluated. All participants were divided into 1 of 2 groups: (1) thymoma with MG (MG group) and (2) thymoma without MG (non-MG group).

It is well known that MG is the most common paraneoplastic syndrome among patients with thymoma—a relatively rare tumor that originates from thymic epithelial cells and is associated with several autoimmune diseases. Moreover, the presence of MG is reported in between 20% and 30% of patients with thymoma.

Among the 145 patients evaluated, 47 comprised the MG arm, and 98 comprised the non-MG arm. Those in the MG group more frequently presented with tumors that measured less than 60 mm and underwent extended thymectomy, compared with those in the non-MG group.

Read more about MG epidemiology

No significant differences were observed with respect to postoperative complications, overall survival (OS), and recurrence-free survival (RFS) between the 2 arms. Any deaths that were reported (n=5) were not caused by thymoma, with no significant difference observed between the groups. Further, in those participants aged more than 60 years, the survival rate in the MG group was lower than that in the non-MG group.

Per univariate analysis, more than 60 years of age was a poor prognostic factor for OS. Per multivariate analysis, however, Masaoka stage 3 and 4 classifications were poor prognostic factors for RFS.

“Surgery can be performed on patients aged ≥60 years with thymoma with MG,” the authors said. Additionally, the postoperative follow-up of patients with thymoma with MG should focus not only on recurrence but also on secondary cancer and the progression of other diseases.

Reference

Miura K, Doi T, Tanaka Y, et al. Effect of myasthenia gravis on the surgical outcomes of patients with thymoma. Asian Cardiovasc Thorac Ann. Published online July 27, 2022. doi:10.1177/02184923221116679