Myasthenia gravis with thymic epithelial tumour: A retrospective analysis of a Japanese database

for the Japanese Association for Research of Thymus

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

OBJECTIVES: Myasthenia gravis (MG) has been reported to correlate with earlier stage and Type B thymomas by the World Health Organization classification. We analysed a large database of clinical characteristics of patients with MG and thymic epithelial tumours to elucidate whether the severity of MG affected postoperative survival of those with thymic epithelial neoplasms. METHODS: We conducted a multi-institutional study on the patients who had undergone surgical treatment for thymic epithelial tumours between 1991 and 2010. We examined Masaoka stage, pathological type, serum titre of antiacetylcholine receptor antigen, severity of MG and postoperative prognosis of the patients with or without MG. RESULTS: Of the 2835 registered patients at 32 institutes belonging to the Japanese Association for Research on the Thymus, 2638 were eligible for the study. MG was present in 598 patients (23%). Patients with MG had thymic epithelial tumours with significantly earlier stage (P = 0.0082) and significantly smaller tumours (P = 0.000) than those without. Type A, Type AB thymomas and thymic carcinomas were less frequently observed in patients with MG. Three of 304 patients (1%) with thymic carcinomas had MG preoperatively. Serum titres of antiacetylcholine receptor antibodies were positive in 98% of patients with MG, and 23% of those without. Patients with generalized MG had significantly higher titres of antiacetylcholine receptor antibodies than those with ocular MG (P = 0.000). The postoperative 30-day mortality rate was 0.3%. Postoperative 5- and 10-year survival rates of thymoma patients with MG and those without MG were 94 and 96, and 89 and 89%, respectively. We found no statistical difference in the postoperative survival rate or recurrence-free rate between the two groups. We found no significant statistical differences of these rates by MGFA classification or surgical approach. CONCLUSIONS: We conclude that earlier stage, smaller size or Type B thymomas are more frequently associated with MG, and MG may have no impact on the overall survival of patients with thymoma. We suggest that postoperative survival time of the patients with MG and thymic epithelial tumours may be mainly affected by the tumours, not by MG.

Original languageEnglish
Pages (from-to)1510-1515
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume49
Issue number5
DOIs
Publication statusPublished - May 1 2016

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Myasthenia Gravis
Databases
Thymoma
Thymic epithelial tumor
Survival
Survival Rate
Thymus Neoplasms
Antigen Receptors
Glandular and Epithelial Neoplasms
Antibodies

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Myasthenia gravis with thymic epithelial tumour : A retrospective analysis of a Japanese database. / for the Japanese Association for Research of Thymus.

In: European Journal of Cardio-thoracic Surgery, Vol. 49, No. 5, 01.05.2016, p. 1510-1515.

Research output: Contribution to journalArticle

for the Japanese Association for Research of Thymus. / Myasthenia gravis with thymic epithelial tumour : A retrospective analysis of a Japanese database. In: European Journal of Cardio-thoracic Surgery. 2016 ; Vol. 49, No. 5. pp. 1510-1515.
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title = "Myasthenia gravis with thymic epithelial tumour: A retrospective analysis of a Japanese database",
abstract = "OBJECTIVES: Myasthenia gravis (MG) has been reported to correlate with earlier stage and Type B thymomas by the World Health Organization classification. We analysed a large database of clinical characteristics of patients with MG and thymic epithelial tumours to elucidate whether the severity of MG affected postoperative survival of those with thymic epithelial neoplasms. METHODS: We conducted a multi-institutional study on the patients who had undergone surgical treatment for thymic epithelial tumours between 1991 and 2010. We examined Masaoka stage, pathological type, serum titre of antiacetylcholine receptor antigen, severity of MG and postoperative prognosis of the patients with or without MG. RESULTS: Of the 2835 registered patients at 32 institutes belonging to the Japanese Association for Research on the Thymus, 2638 were eligible for the study. MG was present in 598 patients (23{\%}). Patients with MG had thymic epithelial tumours with significantly earlier stage (P = 0.0082) and significantly smaller tumours (P = 0.000) than those without. Type A, Type AB thymomas and thymic carcinomas were less frequently observed in patients with MG. Three of 304 patients (1{\%}) with thymic carcinomas had MG preoperatively. Serum titres of antiacetylcholine receptor antibodies were positive in 98{\%} of patients with MG, and 23{\%} of those without. Patients with generalized MG had significantly higher titres of antiacetylcholine receptor antibodies than those with ocular MG (P = 0.000). The postoperative 30-day mortality rate was 0.3{\%}. Postoperative 5- and 10-year survival rates of thymoma patients with MG and those without MG were 94 and 96, and 89 and 89{\%}, respectively. We found no statistical difference in the postoperative survival rate or recurrence-free rate between the two groups. We found no significant statistical differences of these rates by MGFA classification or surgical approach. CONCLUSIONS: We conclude that earlier stage, smaller size or Type B thymomas are more frequently associated with MG, and MG may have no impact on the overall survival of patients with thymoma. We suggest that postoperative survival time of the patients with MG and thymic epithelial tumours may be mainly affected by the tumours, not by MG.",
author = "{for the Japanese Association for Research of Thymus} and Jun Nakajima and Meinoshin Okumura and Motoki Yano and Hiroshi Date and Takuya Onuki and Masayuki Haniuda and Yoshifumi Sano and Ichiro Yoshino and Hisao Asamura and Kazuo Yoshida and Kanji Nagai and Kohei Yokoi and Shinichiro Miyoshi and Masahiko Higashiyama and Kenji Suzuki and Masanori Tsuchida and Shuji Haraguchi and Hiroshi Niwa and Kazuya Kondo and Hirotoshi Horio and Akihide Matsumura and Tatsuro Okamoto and Norihiko Ikeda and Fumihiro Tanaka and Yoshimasa Maniwa and Takamasa Onuki and Makoto Suzuki and Takeshi Nagayasu and Akinori Iwasaki and Hiroshi Suehisa and Yasuhisa Ohde and Tatsuro Okamoto",
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T1 - Myasthenia gravis with thymic epithelial tumour

T2 - A retrospective analysis of a Japanese database

AU - for the Japanese Association for Research of Thymus

AU - Nakajima, Jun

AU - Okumura, Meinoshin

AU - Yano, Motoki

AU - Date, Hiroshi

AU - Onuki, Takuya

AU - Haniuda, Masayuki

AU - Sano, Yoshifumi

AU - Yoshino, Ichiro

AU - Asamura, Hisao

AU - Yoshida, Kazuo

AU - Nagai, Kanji

AU - Yokoi, Kohei

AU - Miyoshi, Shinichiro

AU - Higashiyama, Masahiko

AU - Suzuki, Kenji

AU - Tsuchida, Masanori

AU - Haraguchi, Shuji

AU - Niwa, Hiroshi

AU - Kondo, Kazuya

AU - Horio, Hirotoshi

AU - Matsumura, Akihide

AU - Okamoto, Tatsuro

AU - Ikeda, Norihiko

AU - Tanaka, Fumihiro

AU - Maniwa, Yoshimasa

AU - Onuki, Takamasa

AU - Suzuki, Makoto

AU - Nagayasu, Takeshi

AU - Iwasaki, Akinori

AU - Suehisa, Hiroshi

AU - Ohde, Yasuhisa

AU - Okamoto, Tatsuro

PY - 2016/5/1

Y1 - 2016/5/1

N2 - OBJECTIVES: Myasthenia gravis (MG) has been reported to correlate with earlier stage and Type B thymomas by the World Health Organization classification. We analysed a large database of clinical characteristics of patients with MG and thymic epithelial tumours to elucidate whether the severity of MG affected postoperative survival of those with thymic epithelial neoplasms. METHODS: We conducted a multi-institutional study on the patients who had undergone surgical treatment for thymic epithelial tumours between 1991 and 2010. We examined Masaoka stage, pathological type, serum titre of antiacetylcholine receptor antigen, severity of MG and postoperative prognosis of the patients with or without MG. RESULTS: Of the 2835 registered patients at 32 institutes belonging to the Japanese Association for Research on the Thymus, 2638 were eligible for the study. MG was present in 598 patients (23%). Patients with MG had thymic epithelial tumours with significantly earlier stage (P = 0.0082) and significantly smaller tumours (P = 0.000) than those without. Type A, Type AB thymomas and thymic carcinomas were less frequently observed in patients with MG. Three of 304 patients (1%) with thymic carcinomas had MG preoperatively. Serum titres of antiacetylcholine receptor antibodies were positive in 98% of patients with MG, and 23% of those without. Patients with generalized MG had significantly higher titres of antiacetylcholine receptor antibodies than those with ocular MG (P = 0.000). The postoperative 30-day mortality rate was 0.3%. Postoperative 5- and 10-year survival rates of thymoma patients with MG and those without MG were 94 and 96, and 89 and 89%, respectively. We found no statistical difference in the postoperative survival rate or recurrence-free rate between the two groups. We found no significant statistical differences of these rates by MGFA classification or surgical approach. CONCLUSIONS: We conclude that earlier stage, smaller size or Type B thymomas are more frequently associated with MG, and MG may have no impact on the overall survival of patients with thymoma. We suggest that postoperative survival time of the patients with MG and thymic epithelial tumours may be mainly affected by the tumours, not by MG.

AB - OBJECTIVES: Myasthenia gravis (MG) has been reported to correlate with earlier stage and Type B thymomas by the World Health Organization classification. We analysed a large database of clinical characteristics of patients with MG and thymic epithelial tumours to elucidate whether the severity of MG affected postoperative survival of those with thymic epithelial neoplasms. METHODS: We conducted a multi-institutional study on the patients who had undergone surgical treatment for thymic epithelial tumours between 1991 and 2010. We examined Masaoka stage, pathological type, serum titre of antiacetylcholine receptor antigen, severity of MG and postoperative prognosis of the patients with or without MG. RESULTS: Of the 2835 registered patients at 32 institutes belonging to the Japanese Association for Research on the Thymus, 2638 were eligible for the study. MG was present in 598 patients (23%). Patients with MG had thymic epithelial tumours with significantly earlier stage (P = 0.0082) and significantly smaller tumours (P = 0.000) than those without. Type A, Type AB thymomas and thymic carcinomas were less frequently observed in patients with MG. Three of 304 patients (1%) with thymic carcinomas had MG preoperatively. Serum titres of antiacetylcholine receptor antibodies were positive in 98% of patients with MG, and 23% of those without. Patients with generalized MG had significantly higher titres of antiacetylcholine receptor antibodies than those with ocular MG (P = 0.000). The postoperative 30-day mortality rate was 0.3%. Postoperative 5- and 10-year survival rates of thymoma patients with MG and those without MG were 94 and 96, and 89 and 89%, respectively. We found no statistical difference in the postoperative survival rate or recurrence-free rate between the two groups. We found no significant statistical differences of these rates by MGFA classification or surgical approach. CONCLUSIONS: We conclude that earlier stage, smaller size or Type B thymomas are more frequently associated with MG, and MG may have no impact on the overall survival of patients with thymoma. We suggest that postoperative survival time of the patients with MG and thymic epithelial tumours may be mainly affected by the tumours, not by MG.

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U2 - 10.1093/ejcts/ezv380

DO - 10.1093/ejcts/ezv380

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JO - European Journal of Cardio-thoracic Surgery

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SN - 1010-7940

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