{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:19:48Z","timestamp":1770977988425,"version":"3.50.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,2]],"date-time":"2021-10-02T00:00:00Z","timestamp":1633132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,2]],"date-time":"2021-10-02T00:00:00Z","timestamp":1633132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Transl Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The length of time for clinical improvement of patients with thymomatous myasthenia gravis (MG) after extended thymectomy is not clear. The purpose of this study was to determine the length of time after thymectomy in patients with thymomatous MG to achieve a 3-point reduction of Quantitative Myasthenia Gravis Score (QMGS), and identify variables associated with a failure to achieve the reduction.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The records of patients with thymomatous MG who underwent extended thymectomy from January 2005 to December 2018 were retrospectively reviewed. The primary end point was a reduction of 3 points of QMGs and the secondary end point was another reduction of 3 points of QMGs.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 481 patients were included in the analysis, the mean age of the patients was 41.63\u2009\u00b1\u20098.55\u00a0years, and approximately 60% were male. The median time to achieve a 3 point decrease in QMGS was 6\u00a0months, and the median time to achieve another 3 point decrease was 30\u00a0months. Multivariable analysis indicated that age \u2265\u200942\u00a0years and Masaoka-Koga stage &gt;\u2009I were associated with a lower probability of achieving a 3 point decrease in QMGS (HR\u2009=\u20090.55 and 0.65, respectively). Likewise, multivariable analysis indicated that age \u2265\u200942\u00a0years and Masaoka-Koga stage &gt;\u2009I were associated with a lower probability of achieving a second 3 point decrease in QMGS (HR\u2009=\u20090.53 and 0.53, respectively).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In patients with thymomatous MG who receive thymectomy, age \u2265\u200942\u00a0years and Masaoka-Koga stage &gt;\u2009I are associated with a worse prognosis and failure to achieve a 3 point decrease in QMGS.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12967-021-03082-z","type":"journal-article","created":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T13:42:51Z","timestamp":1633354971000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Factors affecting improvement of neurologic status evaluated by Quantitative Myasthenia Gravis Score for patients with thymomatous myasthenia gravis after extended thymectomy"],"prefix":"10.1186","volume":"19","author":[{"given":"Zhu","family":"Haoshuai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zou","family":"Jianyong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Lei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeng","family":"Bo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiefei","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenguang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su","family":"Chunhua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,2]]},"reference":[{"issue":"1","key":"3082_CR1","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.asjsur.2016.09.006","volume":"41","author":"S Siwachat","year":"2018","unstructured":"Siwachat S, Tantraworasin A, Lapisatepun W, Ruengorn C, Taioli E, Saeteng S. Comparative clinical outcomes after thymectomy for myasthenia gravis: thoracoscopic versus trans-sternal approach. Asian J Surg. 2018;41(1):77\u201385. https:\/\/doi.org\/10.1016\/j.asjsur.2016.09.006.","journal-title":"Asian J Surg"},{"key":"3082_CR2","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.jaut.2013.12.011","volume":"52","author":"S Berrih-Aknin","year":"2014","unstructured":"Berrih-Aknin S, Le Panse R. Myasthenia gravis: a comprehensive review of immune dysregulation and etiological mechanisms. J Autoimmun. 2014;52:90\u2013100. https:\/\/doi.org\/10.1016\/j.jaut.2013.12.011.","journal-title":"J Autoimmun"},{"issue":"25","key":"3082_CR3","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1056\/NEJM199406233302507","volume":"330","author":"DB Drachman","year":"1994","unstructured":"Drachman DB. Myasthenia gravis. N Engl J Med. 1994;330(25):1797\u2013810. https:\/\/doi.org\/10.1056\/NEJM199406233302507.","journal-title":"N Engl J Med"},{"issue":"10","key":"3082_CR4","doi-asserted-by":"publisher","first-page":"2312","DOI":"10.1007\/s00415-018-8995-4","volume":"265","author":"TM Alekseeva","year":"2018","unstructured":"Alekseeva TM, Gavrilov YV, Kreis OA, Valko PO, Weber KP, Valko Y. Fatigue in patients with myasthenia gravis. J Neurol. 2018;265(10):2312\u201321. https:\/\/doi.org\/10.1007\/s00415-018-8995-4.","journal-title":"J Neurol"},{"issue":"6","key":"3082_CR5","doi-asserted-by":"publisher","first-page":"1767","DOI":"10.1212\/CON.0000000000000800","volume":"25","author":"E Ciafaloni","year":"2019","unstructured":"Ciafaloni E. Myasthenia gravis and congenital myasthenic syndromes. Continuum. 2019;25(6):1767\u201384. https:\/\/doi.org\/10.1212\/CON.0000000000000800.","journal-title":"Continuum"},{"key":"3082_CR6","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.expneurol.2015.02.010","volume":"270","author":"A Marx","year":"2015","unstructured":"Marx A, Porubsky S, Belharazem D, Saruhan-Direskeneli G, Schalke B, Str\u00f6bel P, Weis CA. Thymoma related myasthenia gravis in humans and potential animal models. Exp Neurol. 2015;270:55\u201365. https:\/\/doi.org\/10.1016\/j.expneurol.2015.02.010.","journal-title":"Exp Neurol"},{"key":"3082_CR7","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.jneuroim.2008.07.012","volume":"201\u2013202","author":"L Maggi","year":"2008","unstructured":"Maggi L, Andreetta F, Antozzi C, Baggi F, Bernasconi P, Cavalcante P, Cornelio F, Muscolino G, Novellino L, Mantegazza R. Thymoma-associated myasthenia gravis: outcome, clinical and pathological correlations in 197 patients on a 20-year experience. J Neuroimmunol. 2008;201\u2013202:237\u201344. https:\/\/doi.org\/10.1016\/j.jneuroim.2008.07.012.","journal-title":"J Neuroimmunol"},{"issue":"4","key":"3082_CR8","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1097\/CND.0b013e31824619d5","volume":"13","author":"C Barnett","year":"2012","unstructured":"Barnett C, Katzberg H, Nabavi M, Bril V. The quantitative myasthenia gravis score: comparison with clinical, electrophysiological, and laboratory markers. J Clin Neuromuscul Dis. 2012;13(4):201\u20135. https:\/\/doi.org\/10.1097\/CND.0b013e31824619d5.","journal-title":"J Clin Neuromuscul Dis"},{"issue":"3","key":"3082_CR9","doi-asserted-by":"publisher","first-page":"301","DOI":"10.3233\/JND-150082","volume":"2","author":"C Barnett","year":"2015","unstructured":"Barnett C, Merkies IS, Katzberg H, Bril V. Psychometric properties of the quantitative myasthenia gravis score and the myasthenia gravis composite scale. J Neuromuscul Dis. 2015;2(3):301\u201311. https:\/\/doi.org\/10.3233\/JND-150082.","journal-title":"J Neuromuscul Dis"},{"issue":"3","key":"3082_CR10","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/j.jtcvs.2007.05.015","volume":"134","author":"HK Kim","year":"2007","unstructured":"Kim HK, Park MS, Choi YS, Kim K, Shim YM, Han J, Kim BJ, Kim J. Neurologic outcomes of thymectomy in myasthenia gravis: comparative analysis of the effect of thymoma. J Thorac Cardiovasc Surg. 2007;134(3):601\u20137. https:\/\/doi.org\/10.1016\/j.jtcvs.2007.05.015.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"2","key":"3082_CR11","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1053\/j.semtcvs.2016.04.002","volume":"28","author":"AJ Kaufman","year":"2016","unstructured":"Kaufman AJ, Palatt J, Sivak M, Raimondi P, Lee DS, Wolf A, Lajam F, Bhora F, Flores RM. Thymectomy for myasthenia gravis: complete stable remission and associated prognostic factors in over 1000 cases. Semin Thorac Cardiovasc Surg. 2016;28(2):561\u20138. https:\/\/doi.org\/10.1053\/j.semtcvs.2016.04.002.","journal-title":"Semin Thorac Cardiovasc Surg"},{"issue":"11","key":"3082_CR12","doi-asserted-by":"publisher","first-page":"1968","DOI":"10.1212\/01.WNL.0000163988.28892.79","volume":"64","author":"RS Bedlack","year":"2005","unstructured":"Bedlack RS, Simel DL, Bosworth H, Samsa G, Tucker-Lipscomb B, Sanders DB. Quantitative myasthenia gravis score: assessment of responsiveness and longitudinal validity. Neurology. 2005;64(11):1968\u201370. https:\/\/doi.org\/10.1212\/01.WNL.0000163988.28892.79.","journal-title":"Neurology"},{"issue":"6","key":"3082_CR13","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1056\/NEJMoa1602489","volume":"375","author":"GI Wolfe","year":"2016","unstructured":"Wolfe GI, Kaminski HJ, Aban IB, Minisman G, Kuo HC, Marx A, Str\u00f6bel P, Mazia C, Oger J, Cea JG, Heckmann JM, Evoli A, Nix W, Ciafaloni E, Antonini G, Witoonpanich R, King JO, Beydoun SR, Chalk CH, Barboi AC, Amato AA, Shaibani AI, Katirji B, Lecky BR, Buckley C, Vincent A, Dias-Tosta E, Yoshikawa H, Waddington-Cruz M, Pulley MT, Rivner MH, Kostera-Pruszczyk A, Pascuzzi RM, Jackson CE, Garcia Ramos GS, Verschuuren JJ, Massey JM, Kissel JT, Werneck LC, Benatar M, Barohn RJ, Tandan R, Mozaffar T, Conwit R, Odenkirchen J, Sonett JR, Jaretzki A 3rd, Newsom-Davis J, Cutter GR, MGTX Study Group. Randomized trial of thymectomy in myasthenia gravis. N Engl J Med. 2016;375(6):511\u201322. https:\/\/doi.org\/10.1056\/NEJMoa1602489.","journal-title":"N Engl J Med"},{"issue":"2","key":"3082_CR14","first-page":"407","volume":"11","author":"F Dadmanesh","year":"2001","unstructured":"Dadmanesh F, Sekihara T, Rosai J. Histologic typing of thymoma according to the new World Health Organization classification. Chest Surg Clin N Am. 2001;11(2):407\u201320.","journal-title":"Chest Surg Clin N Am"},{"issue":"7 Suppl 3","key":"3082_CR15","doi-asserted-by":"publisher","first-page":"S1710","DOI":"10.1097\/JTO.0b013e31821e8cff","volume":"6","author":"FC Detterbeck","year":"2011","unstructured":"Detterbeck FC, Nicholson AG, Kondo K, Van Schil P, Moran C. The Masaoka-Koga stage classification for thymic malignancies: clarification and definition of terms. J Thorac Oncol. 2011;6(7 Suppl 3):S1710\u20136. https:\/\/doi.org\/10.1097\/JTO.0b013e31821e8cff.","journal-title":"J Thorac Oncol"},{"issue":"5","key":"3082_CR16","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.1016\/s0003-4975(03)01139-1","volume":"76","author":"M L\u00f3pez-Cano","year":"2003","unstructured":"L\u00f3pez-Cano M, Ponseti-Bosch JM, Espin-Basany E, S\u00e1nchez-Garc\u00eda JL, Armengol-Carrasco M. Clinical and pathologic predictors of outcome in thymoma-associated myasthenia gravis. Ann Thorac Surg. 2003;76(5):1643\u20139. https:\/\/doi.org\/10.1016\/s0003-4975(03)01139-1.","journal-title":"Ann Thorac Surg"},{"issue":"2","key":"3082_CR17","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1111\/ane.12289","volume":"131","author":"S Yu","year":"2015","unstructured":"Yu S, Li F, Chen B, Lin J, Yang M, Fu X, Li J, Bu B. Eight-year follow-up of patients with myasthenia gravis after thymectomy. Acta Neurol Scand. 2015;131(2):94\u2013101. https:\/\/doi.org\/10.1111\/ane.12289.","journal-title":"Acta Neurol Scand"},{"issue":"1","key":"3082_CR18","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/s0003-4975(00)01595-2","volume":"70","author":"A Jaretzki 3rd","year":"2000","unstructured":"Jaretzki A 3rd, Barohn RJ, Ernstoff RM, Kaminski HJ, Keesey JC, Penn AS, Sanders DB. Myasthenia gravis: recommendations for clinical research standards. Task force of the medical scientific advisory board of the Myasthenia Gravis Foundation of America. Ann Thorac Surg. 2000;70(1):327\u201334. https:\/\/doi.org\/10.1016\/s0003-4975(00)01595-2.","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"3082_CR19","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1007\/s004150050585","volume":"247","author":"T Sharshar","year":"2000","unstructured":"Sharshar T, Chevret S, Mazighi M, Chillet P, Huberfeld G, Berreotta C, Houfani M, Gajdos P. Validity and reliability of two muscle strength scores commonly used as endpoints in assessing treatment of myasthenia gravis. J Neurol. 2000;247(4):286\u201390. https:\/\/doi.org\/10.1007\/s004150050585.","journal-title":"J Neurol"},{"issue":"12","key":"3082_CR20","doi-asserted-by":"publisher","first-page":"1844","DOI":"10.1212\/01.wnl.0000032502.89361.0c","volume":"59","author":"A Evoli","year":"2002","unstructured":"Evoli A, Minisci C, Di Schino C, Marsili F, Punzi C, Batocchi AP, Tonali PA, Doglietto GB, Granone P, Trodella L, Cassano A, Lauriola L. Thymoma in patients with MG: characteristics and long-term outcome. Neurology. 2002;59(12):1844\u201350. https:\/\/doi.org\/10.1212\/01.wnl.0000032502.89361.0c.","journal-title":"Neurology"},{"issue":"3","key":"3082_CR21","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1002\/cncr.10226","volume":"94","author":"M Okumura","year":"2002","unstructured":"Okumura M, Ohta M, Tateyama H, Nakagawa K, Matsumura A, Maeda H, Tada H, Eimoto T, Matsuda H, Masaoka A. The World Health Organization histologic classification system reflects the oncologic behavior of thymoma: a clinical study of 273 patients. Cancer. 2002;94(3):624\u201332. https:\/\/doi.org\/10.1002\/cncr.10226.","journal-title":"Cancer"},{"issue":"5","key":"3082_CR22","doi-asserted-by":"publisher","first-page":"2981","DOI":"10.21037\/jtd.2018.05.30","volume":"10","author":"J Shen","year":"2018","unstructured":"Shen J, Tie H, Xu A, Chen D, Ma D, Zhang B, Zhu C, Wu Q. Inter-relationship among myasthenia gravis, WHO histology, and Masaoka clinical stage and effect on surgical methods in patients with thymoma: a retrospective cohort study. J Thorac Dis. 2018;10(5):2981\u201390. https:\/\/doi.org\/10.21037\/jtd.2018.05.30.","journal-title":"J Thorac Dis"},{"issue":"6","key":"3082_CR23","doi-asserted-by":"publisher","first-page":"2328","DOI":"10.1016\/j.athoracsur.2005.11.067","volume":"81","author":"FC Detterbeck","year":"2006","unstructured":"Detterbeck FC. Clinical value of the WHO classification system of thymoma. Ann Thorac Surg. 2006;81(6):2328\u201334. https:\/\/doi.org\/10.1016\/j.athoracsur.2005.11.067.","journal-title":"Ann Thorac Surg"},{"issue":"1","key":"3082_CR24","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.athoracsur.2004.06.090","volume":"79","author":"K Kondo","year":"2005","unstructured":"Kondo K, Monden Y. Thymoma and myasthenia gravis: a clinical study of 1,089 patients from Japan. Ann Thorac Surg. 2005;79(1):219\u201324. https:\/\/doi.org\/10.1016\/j.athoracsur.2004.06.090.","journal-title":"Ann Thorac Surg"},{"key":"3082_CR25","doi-asserted-by":"publisher","first-page":"S1698","DOI":"10.1097\/JTO.0b013e31821e7b12","volume":"6","author":"F Detterbeck","year":"2011","unstructured":"Detterbeck F, Youssef S, Ruffini E, Okumura M. A review of prognostic factors in thymic malignancies. J Thorac Oncol. 2011;6:S1698\u2013704.","journal-title":"J Thorac Oncol"},{"issue":"1","key":"3082_CR26","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1111\/1759-7714.13724","volume":"12","author":"A De Rosa","year":"2021","unstructured":"De Rosa A, Fornili M, Maestri Tassoni M, Guida M, Baglietto L, Petrucci L, Chella A, Melfi F, Lucchi M, Ricciardi R. Thymoma-associated myasthenia gravis: Clinical features and predictive value of antiacetylcholine receptor antibodies in the risk of recurrence of thymoma. Thorac Cancer. 2021;12(1):106\u201313. https:\/\/doi.org\/10.1111\/1759-7714.13724.","journal-title":"Thorac Cancer"}],"container-title":["Journal of Translational Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12967-021-03082-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12967-021-03082-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12967-021-03082-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T13:53:45Z","timestamp":1633355625000},"score":1,"resource":{"primary":{"URL":"https:\/\/translational-medicine.biomedcentral.com\/articles\/10.1186\/s12967-021-03082-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,2]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3082"],"URL":"https:\/\/doi.org\/10.1186\/s12967-021-03082-z","relation":{},"ISSN":["1479-5876"],"issn-type":[{"value":"1479-5876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,2]]},"assertion":[{"value":"14 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Committee on Clinical Investigations of the First Affiliated Hospital of Sun-Yat-sen University. Because of the retrospective nature of the study, the requirement of informed patient consent was waived. All authors have read and approve this version of the article, and due care has been taken to ensure the integrity of the work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"This article does not contain any individual person\u2019s data in any form.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"This paper, totally or partly, has not been published or submitted elsewhere. There is no conflict of interest in whichever form at the submission of this manuscript. No funding.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"413"}}