title: Eight-year follow-up of patients with myasthenia gravis after thymectomy.
abstract: OBJECTIVE
  To depict the long-term outcome of patients with myasthenia gravis after thymectomy in combination with immunotherapy, and the factors that may potentially affect the outcome.
  
  
  METHODS
  The 306 patients with myasthenia gravis who underwent extended thymectomy from January 1984 to December 2011 at Tongji Hospital were retrospectively evaluated.
  
  
  RESULTS
  The patients consisted of 174 cases with thymoma and 132 cases without thymoma. Pharmaceutical treatment was tailored for each case during follow-up. Nine patients with thymomatous myasthenia gravis died during the perioperative period, and 297 patients were followed for 8.6 years. By their latest visits, 241 patients (81.1%) gained satisfactory efficacy, 24 cases died (8.1%), and 32 cases (10.8%) remained unchanged or deteriorated. Favorable factors for satisfactory efficacy included the presence of ocular myasthenia gravis before operation, no presence of thymoma, and lack of concomitant diseases. It is interesting to mention that, patients with non-thymomatous myasthenia gravis obtained significantly higher rates of complete stable remission and clinical remission than the patients with thymomatous myasthenia gravis.
  
  
  CONCLUSIONS
  Extended thymectomy combined with immunotherapy is a preferred treatment with a satisfactory long-term remission rate. Patients with non-thymomatous myasthenia gravis have a much more promising prognosis than the patients with thymomatous myasthenia gravis. However, appropriate caution must be taken to discontinue pharmaceutical therapy as relapse remains a major concern after a patient who has already undergone thymectomy becomes symptom-free.
authors.affiliation: Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: S
authors.initials: S
authors.lastname: Yu
authors.forename: F
authors.initials: F
authors.lastname: Li
authors.forename: B
authors.initials: B
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Lin
authors.forename: M
authors.initials: M
authors.lastname: Yang
authors.forename: X
authors.initials: X
authors.lastname: Fu
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: B
authors.initials: B
authors.lastname: Bu
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013934:Thymectomy; D013945:Thymoma / Q000150:complications; D013953:Thymus Neoplasms / Q000150:complications
chemical_list: D007166:Immunosuppressive Agents
keywords: long-term outcome; myasthenia gravis; non-thymoma; thymectomy; thymoma