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. 2025 Jan 1;111(1):1521-1525.
doi: 10.1097/JS9.0000000000001981.

A new pragmatic classification system for thymoma-associated myasthenia gravis: a retrospective cohort study

Yongqiang Ao  1   2 , Jiahao Jiang  1   2 , Junjie Miao  3 , Jian Gao  1   2 , Xinyu Yang  1   2 , Yuansheng Zheng  1   2 , Fei Liang  2   4 , Shuai Wang  1   2 , Jihong Dong  3 , Jianyong Ding  1   2
Affiliations

A new pragmatic classification system for thymoma-associated myasthenia gravis: a retrospective cohort study

Yongqiang Ao et al. Int J Surg. .

Abstract

The management and outcomes of patients with thymoma-associated myasthenia gravis (TAMG) are heterogeneous. Here, the authors propose a novel classification system based on Masaoka stage and Myasthenia Gravis Foundation of America (MGFA) classification, aiming to guide surgical decisions and perioperative management for these patients. Considering both oncological and neurological factors, this novel TAMG classification provides valuable information on outcome stratification and clinical decision-making for TAMG.

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Conflict of interest statement

The authors declare no conflicts interests.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Stratification of patients with TAMG and its association with MG remission. (A) Patients with TAMG were stratified using the Masaoka staging system and MGFA classification. (B) The percentage of TAMG patients in different remission statuses at various time points. (C) Calibration curves of different classification systems predicting MG regression in TAMG patients. CSR, Complete stable remission; MGFA, Myasthenia Gravis Foundation of America; MM, Minimal manifestation; PR, Pharmacological remission; TAMG, Thymoma-associated myasthenia gravis.
Figure 2
Figure 2
The novel TAMG classification and its prediction of patient survival. (A) Association of the novel TAMG classification with overall survival (OS) and tumor recurrence. (B) Calibration curves of different classification systems for predicting OS in TAMG patients. (C) Comparison of postoperative outcomes, including MG-ADL scores and hospital stay length, among different TAMG subtypes using an unpaired student’s t-test. (D) Postoperative occurrence of myasthenia crisis (MC) among different TAMG subtypes and MGFA classifications. MC, Myasthenia crisis; MGFA, Myasthenia Gravis Foundation of America; MG-ADL, MG activities of daily living scores; OS, Overall survival; TAMG, Thymoma-associated myasthenia gravis. The P-values are indicated as n.s. (P>0.05), *(P<0.05), **(P<0.01), ***(P<0.001), ****(P<0.0001).
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