Does Myasthenia Gravis Affect Long-Term Survival in Thymic Carcinomas? An ESTS Database Analysis
Abstract
:1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
4. Discussion
4.1. Association between MG and TC and Clinical Features
4.2. Long-Term Survival Results
4.3. MG and Long-Term Survival
4.4. Limitations and Points of Strength
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | MG Patients | Non-MG Patients | p-Value | |
---|---|---|---|---|
(#22) | (#181) | |||
Gender | Male | 17 (77.3%) | 79 (43.6%) | 0.003 |
Female | 5 (22.7%) | 102 (56.4%) | ||
Age ≥ 60 years | 0 | 14 (63.6%) | 75 (41.4%) | |
1 | 8 (36.4%) | 106 (58.6%) | 0.05 | |
ECOG | 0 | 2 (9%) | 51 (28.2%) | 0.29 |
1 | 1 (4.5%) | 34 (18.8%) | ||
2 | 2 (9%) | 9 (4.1%) | ||
3 | 0 (0%) | 3 (1.7%) | ||
4 | 0 (0%) | 2 (1.1%) | ||
Missing data | 17 (77.5%) | 82 (46.1%) | ||
Neoadjuvant Therapy | 0 | 18 (81.8%) | 59 (32.6%) | 0.61 |
1 | 4 (18.2%) | 18 (9.9%) | ||
Missing data | 0 (0%) | 104 (57.5%) | ||
Surgical access | Sternotomy | 8 (36.4%) | 70 (38.7%) | 0.33 |
Thoracotomy | 0 (0%) | 33 (18.2%) | ||
Clamshell | 0 (0%) | 2 (1.1%) | ||
Emiclamshell | 0 (0%) | 5 (2.7%) | ||
Sternotomy + Thoracotomy | 0 (0%) | 6 (3.3%) | ||
VATS | 2 (9.1%) | 8 (4.4%) | ||
RATS | 2 (9.1%) | 5 (2.8%) | ||
Missing data | 10 (45.4%) | 52 (28.8%) | ||
Masaoka stage | I | 7 (31.8%) | 46 (25.4%) | 0.03 |
IIa | 5 (22.7%) | 26 (14.4%) | ||
IIb | 4 (18.2%) | 32 (17.7%) | ||
III | 3 (13.6%) | 54 (29.8%) | ||
IVa | 2 (9.1%) | 15 (8.3%) | ||
IVb | 1 (4.6%) | 8 (4.4%) | ||
Complete Resection | R0 | 18 (81.8%) | 140 (77.3%) | 0.85 |
R+ | 4 (18.2%) | 41 (22.6%) | ||
Adjuvant therapy | 0 | 9 (40.9%) | 89 (49.2%) | 0.06 |
1 | 13 (59.1%) | 55 (30.4%) | ||
Missing data | 0 (0%) | 37 (20.4%) | ||
Type of therapy | Chemotherapy | 1 (4.5%) | 4 (2.2%) | <<0.001 |
Radiotherapy | 7 (31.8%) | 53 (29.3%) | ||
Chemo-radiotherapy | 1 (4.5%) | 2 (1.1%) |
Variables | Univariable Analysis | Multivariable Analysis | ||
---|---|---|---|---|
HR [95% CI] | p-Value | HR [95% CI] | p-Value | |
Female gender | 0.6 [0.3–1.0] | 0.063 | 0.4 [0.2–1.0] | 0.05 * |
Age < 60 years | 0.5 [0.3–0.9] | 0.039 * | 0.1 [0.0–0.4] | 0.001 * |
Myasthenia Gravis | 1.9 [0.9–4.5] | 0.096 | 8.7 [0.8–95.3] | 0.07 |
Minimally invasive approach | 1.0 [0.2–4.6] | 0.67 | ||
Masaoka stage ≤ IIa | 0.2 [0.4–0.9] | 0.04 * | 0.4 [0.2–0.8] | <<0.001 * |
R0 resection | 0.7 [0.1–5.2] | 0.006 * | 0.2 [0.0–2.1] | 0.2 |
Adjuvant radiotherapy | 0.6 [0.3–1.1] | 0.003 * | 0.5 [0.2–0.8] | <<0.001 * |
Variables | Univariable Analysis | Multivariable Analysis | ||
---|---|---|---|---|
HR [95% CI] | p-Value | HR [95% CI] | p-Value | |
Female gender | 0.197 | 0.3 [0.1–0.8] | 0.017 | |
Age < 60 years | 0.007 * | 0.1 [0.0-0.5] | 0.001 * | |
Myasthenia Gravis | 0.345 | |||
Minimally invasive approach | 0.834 | |||
Masaoka stage ≤ IIa | 0.04 * | 0.7 [0.2–3.9] | 0.001 * | |
Adjuvant radiotherapy | 0.565 |
# | Radicality | 5-Years OS | Variables Affecting Survival | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Gender | Age | M.G. | Masaoka Stage | R0 | Post-op RT | Post-op CHT | ||||
Weksler (2013) | 290 | 56% | 0% | X | - | - | X | X | - | - |
Ruffini (2014) | 229 | 69% | 61% | - | - | - | X | X | X | - |
Ahmad (2015) | 1042 | 61% | 60% | - | - | - | X | X | X | X |
Li (2016) | 49 | 61% | ≈50% | - | - | X | - | X | - | - |
Fu (2016) | 329 | 58% | 67% | - | - | - | X | X | X | - |
Present series (2021) | 203 | 78% | 75% | X | X | - | X | X | X | - |
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Lococo, F.; Nachira, D.; Chiappetta, M.; Evangelista, J.; Falcoz, P.E.; Ruffini, E.; Van Schil, P.; Scarci, M.; Furàk, J.; Sollitto, F.; et al. Does Myasthenia Gravis Affect Long-Term Survival in Thymic Carcinomas? An ESTS Database Analysis. Diagnostics 2022, 12, 1764. https://doi.org/10.3390/diagnostics12071764
Lococo F, Nachira D, Chiappetta M, Evangelista J, Falcoz PE, Ruffini E, Van Schil P, Scarci M, Furàk J, Sollitto F, et al. Does Myasthenia Gravis Affect Long-Term Survival in Thymic Carcinomas? An ESTS Database Analysis. Diagnostics. 2022; 12(7):1764. https://doi.org/10.3390/diagnostics12071764
Chicago/Turabian StyleLococo, Filippo, Dania Nachira, Marco Chiappetta, Jessica Evangelista, Pierre Emmanuel Falcoz, Enrico Ruffini, Paul Van Schil, Marco Scarci, Jòzsef Furàk, Francesco Sollitto, and et al. 2022. "Does Myasthenia Gravis Affect Long-Term Survival in Thymic Carcinomas? An ESTS Database Analysis" Diagnostics 12, no. 7: 1764. https://doi.org/10.3390/diagnostics12071764
APA StyleLococo, F., Nachira, D., Chiappetta, M., Evangelista, J., Falcoz, P. E., Ruffini, E., Van Schil, P., Scarci, M., Furàk, J., Sollitto, F., Guerrera, F., Spaggiari, L., Aigner, C., Evangelia, L., Billè, A., Moser, B., Thomas, P. A., Liberman, M., Boubia, S., ... ESTS Thymic Working Group. (2022). Does Myasthenia Gravis Affect Long-Term Survival in Thymic Carcinomas? An ESTS Database Analysis. Diagnostics, 12(7), 1764. https://doi.org/10.3390/diagnostics12071764