Risk factors for developing postthymectomy myasthenia gravis in thymoma patients

Yoshito Yamada, Shigetoshi Yoshida, Takekazu Iwata, Hidemi Suzuki, Tetsuzo Tagawa, Teruaki Mizobuchi, Naoki Kawaguchi, Ichiro Yoshino

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background Thymoma patients with no prior history of myasthenia gravis (MG) occasionally have MG after thymectomy. This study aimed to identify risk factors for developing postthymectomy MG. Methods We retrospectively reviewed the characteristics and clinical outcomes of thymoma patients without preoperative MG who underwent a thymectomy at our institute. Results Of the 229 thymoma patients who underwent surgery from 1991 to 2011, 123 had no history of MG. The serum of all patients was analyzed for acetylcholine receptor antibodies (AchR-Ab), and 33 patients had detectable levels (greater than 0.2 nmol/L). Ten seropositive patients had MG develop postoperatively within 3 to 2,859 days, whereas 90 seronegative patients did not. Univariate analysis showed that a positive result for serum AchR-Ab (p < 0.001), type B1/B2/B3 thymoma histology (p = 0.025), and incomplete resection (p = 0.008) were risk factors for the development of MG. In patients with post-thymectomy MG, the AchR-Ab levels at the onset of MG were significantly higher than the preoperative levels (p = 0.036). The analysis of the 33 antibody-positive patients showed a significant correlation between antibody levels and the onset of disease (p = 0.003). The analysis of 12 patients with incomplete resection revealed that perioperative chemotherapy or radiotherapy reduced the risk of development of MG (p = 0.009). Conclusions A positive result for serum AchR-Ab, type B1/B2/B3 thymoma histology, and incomplete resection were considered risk factors for the development of postthymectomy MG. Preoperative levels of serum AchR-Ab should be examined in all thymoma patients. Perioperative chemotherapy or radiotherapy for the patients with incomplete resection might reduce the risk of MG development.

Original languageEnglish
Pages (from-to)1013-1019
Number of pages7
JournalAnnals of Thoracic Surgery
Volume99
Issue number3
DOIs
Publication statusPublished - Jan 1 2015
Externally publishedYes

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Thymoma
Myasthenia Gravis
Cholinergic Receptors
Antibodies
Thymectomy
Serum
Histology
Radiotherapy
Drug Therapy

All Science Journal Classification (ASJC) codes

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

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Risk factors for developing postthymectomy myasthenia gravis in thymoma patients. / Yamada, Yoshito; Yoshida, Shigetoshi; Iwata, Takekazu; Suzuki, Hidemi; Tagawa, Tetsuzo; Mizobuchi, Teruaki; Kawaguchi, Naoki; Yoshino, Ichiro.

In: Annals of Thoracic Surgery, Vol. 99, No. 3, 01.01.2015, p. 1013-1019.

Research output: Contribution to journalArticle

Yamada, Y, Yoshida, S, Iwata, T, Suzuki, H, Tagawa, T, Mizobuchi, T, Kawaguchi, N & Yoshino, I 2015, 'Risk factors for developing postthymectomy myasthenia gravis in thymoma patients', Annals of Thoracic Surgery, vol. 99, no. 3, pp. 1013-1019. https://doi.org/10.1016/j.athoracsur.2014.10.068
Yamada, Yoshito ; Yoshida, Shigetoshi ; Iwata, Takekazu ; Suzuki, Hidemi ; Tagawa, Tetsuzo ; Mizobuchi, Teruaki ; Kawaguchi, Naoki ; Yoshino, Ichiro. / Risk factors for developing postthymectomy myasthenia gravis in thymoma patients. In: Annals of Thoracic Surgery. 2015 ; Vol. 99, No. 3. pp. 1013-1019.
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abstract = "Background Thymoma patients with no prior history of myasthenia gravis (MG) occasionally have MG after thymectomy. This study aimed to identify risk factors for developing postthymectomy MG. Methods We retrospectively reviewed the characteristics and clinical outcomes of thymoma patients without preoperative MG who underwent a thymectomy at our institute. Results Of the 229 thymoma patients who underwent surgery from 1991 to 2011, 123 had no history of MG. The serum of all patients was analyzed for acetylcholine receptor antibodies (AchR-Ab), and 33 patients had detectable levels (greater than 0.2 nmol/L). Ten seropositive patients had MG develop postoperatively within 3 to 2,859 days, whereas 90 seronegative patients did not. Univariate analysis showed that a positive result for serum AchR-Ab (p < 0.001), type B1/B2/B3 thymoma histology (p = 0.025), and incomplete resection (p = 0.008) were risk factors for the development of MG. In patients with post-thymectomy MG, the AchR-Ab levels at the onset of MG were significantly higher than the preoperative levels (p = 0.036). The analysis of the 33 antibody-positive patients showed a significant correlation between antibody levels and the onset of disease (p = 0.003). The analysis of 12 patients with incomplete resection revealed that perioperative chemotherapy or radiotherapy reduced the risk of development of MG (p = 0.009). Conclusions A positive result for serum AchR-Ab, type B1/B2/B3 thymoma histology, and incomplete resection were considered risk factors for the development of postthymectomy MG. Preoperative levels of serum AchR-Ab should be examined in all thymoma patients. Perioperative chemotherapy or radiotherapy for the patients with incomplete resection might reduce the risk of MG development.",
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T1 - Risk factors for developing postthymectomy myasthenia gravis in thymoma patients

AU - Yamada, Yoshito

AU - Yoshida, Shigetoshi

AU - Iwata, Takekazu

AU - Suzuki, Hidemi

AU - Tagawa, Tetsuzo

AU - Mizobuchi, Teruaki

AU - Kawaguchi, Naoki

AU - Yoshino, Ichiro

PY - 2015/1/1

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N2 - Background Thymoma patients with no prior history of myasthenia gravis (MG) occasionally have MG after thymectomy. This study aimed to identify risk factors for developing postthymectomy MG. Methods We retrospectively reviewed the characteristics and clinical outcomes of thymoma patients without preoperative MG who underwent a thymectomy at our institute. Results Of the 229 thymoma patients who underwent surgery from 1991 to 2011, 123 had no history of MG. The serum of all patients was analyzed for acetylcholine receptor antibodies (AchR-Ab), and 33 patients had detectable levels (greater than 0.2 nmol/L). Ten seropositive patients had MG develop postoperatively within 3 to 2,859 days, whereas 90 seronegative patients did not. Univariate analysis showed that a positive result for serum AchR-Ab (p < 0.001), type B1/B2/B3 thymoma histology (p = 0.025), and incomplete resection (p = 0.008) were risk factors for the development of MG. In patients with post-thymectomy MG, the AchR-Ab levels at the onset of MG were significantly higher than the preoperative levels (p = 0.036). The analysis of the 33 antibody-positive patients showed a significant correlation between antibody levels and the onset of disease (p = 0.003). The analysis of 12 patients with incomplete resection revealed that perioperative chemotherapy or radiotherapy reduced the risk of development of MG (p = 0.009). Conclusions A positive result for serum AchR-Ab, type B1/B2/B3 thymoma histology, and incomplete resection were considered risk factors for the development of postthymectomy MG. Preoperative levels of serum AchR-Ab should be examined in all thymoma patients. Perioperative chemotherapy or radiotherapy for the patients with incomplete resection might reduce the risk of MG development.

AB - Background Thymoma patients with no prior history of myasthenia gravis (MG) occasionally have MG after thymectomy. This study aimed to identify risk factors for developing postthymectomy MG. Methods We retrospectively reviewed the characteristics and clinical outcomes of thymoma patients without preoperative MG who underwent a thymectomy at our institute. Results Of the 229 thymoma patients who underwent surgery from 1991 to 2011, 123 had no history of MG. The serum of all patients was analyzed for acetylcholine receptor antibodies (AchR-Ab), and 33 patients had detectable levels (greater than 0.2 nmol/L). Ten seropositive patients had MG develop postoperatively within 3 to 2,859 days, whereas 90 seronegative patients did not. Univariate analysis showed that a positive result for serum AchR-Ab (p < 0.001), type B1/B2/B3 thymoma histology (p = 0.025), and incomplete resection (p = 0.008) were risk factors for the development of MG. In patients with post-thymectomy MG, the AchR-Ab levels at the onset of MG were significantly higher than the preoperative levels (p = 0.036). The analysis of the 33 antibody-positive patients showed a significant correlation between antibody levels and the onset of disease (p = 0.003). The analysis of 12 patients with incomplete resection revealed that perioperative chemotherapy or radiotherapy reduced the risk of development of MG (p = 0.009). Conclusions A positive result for serum AchR-Ab, type B1/B2/B3 thymoma histology, and incomplete resection were considered risk factors for the development of postthymectomy MG. Preoperative levels of serum AchR-Ab should be examined in all thymoma patients. Perioperative chemotherapy or radiotherapy for the patients with incomplete resection might reduce the risk of MG development.

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