Long-term prognosis in patients with thymoma combined with myasthenia gravis: a propensity score-matching analysis

Kai Zhao, Yiming Liu, M. Jing, Wenhan Cai, Jiamei Jin, Zirui Zhu, Leilei Shen, Jiaxin Wen, Zhiqiang Xue
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Abstract

We aimed to assess the impact of myasthenia gravis (MG) on the long-term prognosis in patients with thymoma after surgery and identify related prognostic factors or predictors.This retrospective observational study included 509 patients with thymoma (thymoma combined with MG [MG group] and thymoma alone [non-MG group]). Propensity score matching was performed to obtain comparable subsets of 96 patients in each group. A comparative analysis was conducted on various parameters.Before matching, the 10-year survival and recurrence-free survival rates in both groups were 93.8 and 98.4%, and 85.9 and 93.4%, respectively, with no statistically significant difference observed in the survival curves between the groups (p > 0.05). After propensity score matching, 96 matched pairs of patients from both groups were created. The 10-year survival and recurrence-free survival rates in these matched pairs were 96.9 and 97.7%, and 86.9 and 91.1%, respectively, with no statistical significance in the survival curves between the groups (p > 0.05). Univariate analysis of patients with thymoma postoperatively revealed that the World Health Organization histopathological classification, Masaoka–Koga stage, Tumor Node Metastasis stage, resection status, and postoperative adjuvant therapy were potentially associated with tumor recurrence after thymoma surgery. Multivariate analysis demonstrated that the Masaoka–Koga stage and postoperative adjuvant therapy independently predicted the risk of recurrence in patients with thymoma after surgery.There was no difference in prognosis in patients with thymoma with or without MG. The Masaoka–Koga stage has emerged as an independent prognostic factor affecting recurrence-free survival in patients with thymoma, while postoperative adjuvant therapy represents a poor prognostic factor.
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胸腺瘤合并重症肌无力患者的长期预后:倾向得分匹配分析
我们的目的是评估肌无力(MG)对胸腺瘤患者术后长期预后的影响,并找出相关的预后因素或预测因子。这项回顾性观察研究共纳入了509例胸腺瘤患者(胸腺瘤合并MG[MG组]和单纯胸腺瘤[非MG组])。研究人员对每组 96 名患者进行了倾向评分匹配,以获得具有可比性的子集。匹配前,两组患者的 10 年生存率和无复发生存率分别为 93.8% 和 98.4%,以及 85.9% 和 93.4%,组间生存曲线差异无统计学意义(P>0.05)。经过倾向评分匹配后,两组共有 96 对匹配患者。这些配对患者的 10 年生存率和无复发生存率分别为 96.9% 和 97.7%,以及 86.9% 和 91.1%,组间生存曲线差异无统计学意义(P > 0.05)。对胸腺瘤患者术后进行的单变量分析显示,世界卫生组织组织病理学分类、Masaoka-Koga分期、肿瘤结节转移分期、切除状态和术后辅助治疗与胸腺瘤术后肿瘤复发有潜在关联。多变量分析表明,Masaoka-Koga分期和术后辅助治疗可独立预测胸腺瘤患者术后复发的风险。Masaoka-Koga分期已成为影响胸腺瘤患者无复发生存期的独立预后因素,而术后辅助治疗则是不良预后因素。
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