{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T06:22:07Z","timestamp":1782627727490,"version":"3.54.5"},"reference-count":52,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371411"],"award-info":[{"award-number":["82371411"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Outcomes after thymectomy differ greatly between non-thymomatous and thymomatous myasthenia gravis (MG), meriting an in-depth exploration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To examine the treatment and prognosis of non-thymomatous and thymomatous MG patients after thymectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A multicenter, retrospective, case\u2013control study focused on MG patients following thymectomy from November 2010 to January 2024. After propensity score matching, 284 patients (142 with non-thymomatous MG and 142 with thymomatous MG) were included, with a median follow-up of 2.94\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Four outcomes were examined: minimal manifestations status (MMS) or better at the final visit, sustained clinical response, postoperative myasthenic crisis, and long-term mortality. Kaplan\u2013Meier, logistic regression, cox regression, nomogram, receiver operating characteristic curve, decision curve, and calibration curve analyses were used for assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Non-thymoma patients had a lower proportion of postoperative myasthenic crisis (5.6% vs 13.4%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.026) and long-term mortality (1.4% vs 9.9%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002) but a higher proportion of sustained clinical response (66.2% vs 52.1%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.016) than thymoma patients. For both non-thymomatous and thymomatous MG, anti-acetylcholine receptor antibody (AChR-Ab) positivity was the independent predictor for MMS or better at the final visit (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.048;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.016) and sustained clinical response (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.035;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.037). Most severe Myasthenia Gravis Foundation of America (MGFA) classification and high-grade Masaoka histopathology were independent predictors for postoperative myasthenic crisis (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.010) and long-term mortality (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.006;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.014) for thymomatous MG. Postoperative prednisone combined with tacrolimus (Pred\u2009+\u2009TAC) was associated with achieving sustained clinical response (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.026;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.030) and prednisone tapering for both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Non-thymomatous MG exhibited a more benign course with better outcomes. AChR-Ab positivity indicated a better prognosis for both groups, while thymomatous MG with severe MGFA classification and high-grade histopathology requires close monitoring and follow-up. Postoperative Pred\u2009+\u2009TAC could be an effective immunotherapy option for beneficial outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562864251343573","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T22:56:46Z","timestamp":1750460206000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of outcomes and postoperative immunotherapy between patients with non-thymomatous and thymomatous myasthenia gravis following thymectomy"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5094-2747","authenticated-orcid":false,"given":"Qing","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"},{"name":"Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong 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