{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:00:45Z","timestamp":1788782445644,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82301587"],"award-info":[{"award-number":["82301587"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2017YFC0907700"],"award-info":[{"award-number":["2017YFC0907700"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Limited evidence has led to ongoing debate about the benefits of thymectomy for late\u2010onset myasthenia gravis (LOMG). This study aims to compare the outcomes of patients with LOMG who underwent thymectomy versus those who received medical treatment alone, and evaluate the incidence of surgical adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Non\u2010thymomatous acetylcholine\u2010receptor antibody positive patients with LOMG were selected from a multi\u2010center longitudinal clinical database. Rates of and time to response (remission and minimal manifestations status) were compared between 2 groups by propensity score matching (PSM), Kaplan\u2013Meier analysis, and Cox regression models. Additionally, the incidence of adverse events about thymectomy was compared between LOMG and younger patients with myasthenia gravis (MG) aged 40 to 50\u2009years old.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 55 and 210 patients with LOMG were enrolled in the thymectomy and medical treatment groups, respectively. The thymectomy group exhibited significantly younger onset age (56.31\u2009\u00b1\u20096.15 vs. 62.04\u2009\u00b1\u20097.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). After PSM adjustment, thymectomy demonstrated a greater cumulative probability (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and the 2.356\u2010fold (95% confidence interval [CI]\u2009=\u20091.537\u20133.612,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) higher chance of better outcomes compared to medical treatment. In subgroup analysis, thymectomy showed significantly higher response rates compared to medical treatment alone at 24\u2009\u00b1\u20092\u2009months (48.9%, 95% CI\u2009=\u200933.7\u201364.1% vs 23.8%, 95% CI\u2009=\u200914.2\u201333.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), and 36\u2009\u00b1\u20092\u2009months (59.5%, 95% CI\u2009=\u200942.9\u201376.1% vs 28.9%, 95% CI\u2009=\u200918.5\u201339.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). The incidences of adverse events were comparable between patients with LOMG and younger patients with MG (32.0% vs 22.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.286).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Thymectomy may be an effective therapeutic option for LOMG. Our findings highlight the need for further development of a randomized trial targeting patients with LOMG. ANN NEUROL 2026;99:629\u2013638<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.78093","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T13:12:31Z","timestamp":1763989951000},"page":"629-638","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Thymectomy in Late\u2010Onset Myasthenia Gravis: A Multi\u2010Center Longitudinal Retrospective Study"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3507-6991","authenticated-orcid":false,"given":"Jiaxin","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital Sun Yat\u2010sen University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6023-021X","authenticated-orcid":false,"given":"Chunhua","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, The First Affiliated Hospital Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital Sun Yat\u2010sen University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital Sun Yat\u2010sen University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital Sun Yat\u2010sen University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, The First Affiliated Hospital Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital Sun Yat\u2010sen University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases  Guangzhou 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