https://www.annalsthoracicsurgery.org/article/S0003-4975(03)00555-1/pdf

Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan

The Quality Standards Subcommittee of the American Academy of Neurology is charged with developing practice parameters for neurologists for diagnostic procedures, treatment modalities, and clinical disorders. The selection of topics for which practice parameters are used is based on prevalence, frequency of use, economic impact, membership involvement, controversy, urgency, external constraints, and resources required. This paper addresses the role of thymectomy in the treatment of nonthymomatous autoimmune MG.

In 1939, Blalock et al.1 reported the remission of generalized MG in a 21-year-old woman after removal of a cystic thymic tumor. Subsequently, Blalock et al.2,3 performed thymectomy on MG patients without thymoma, found hyperplasia in the thymus glands, and reported improvement in at least half of their patients. Since these reports, thymectomy, with or without the presence of thymoma, has gained widespread acceptance as a form of treatment for MG.

Because a definitive study of the effectiveness of thymectomy has never been done,4,5 the role of thymectomy in the management of MG remains uncertain. Nevertheless, physicians have to advise their patients regarding the benefits of thymectomy based on the existing literature. Our goal is to develop evidence-based recommendations for clinicians considering thymectomy for patients with nonthymomatous autoimmune MG by performing a systematic review and analysis of the literature.

### Identification and selection of studies.

We searched the National Library of Medicine’s Medline database from 1966 to February 1998 using the medical subject headings “myasthenia gravis” (restricted to the surgery subheading) and “thymectomy.” To identify articles published before 1966, or missed by our original search strategy, we reviewed the references of the identified articles.

We classified the resulting articles into the following categories: Class II, controlled but nonrandomized studies describing outcomes in MG patients with and without thymectomy; and Class III, uncontrolled case series describing outcomes in patients with or without …

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Practice parameter: Thymectomy for autoimmune myasthenia gravis (an evidence-based review) Report of the Quality Standards Subcommittee of the American Academy of Neurology

Prognostic factors and long-term results after thymoma resection: A series of 307 patients

https://www.annalsthoracicsurgery.org/article/0003-4975(95)00669-C/pdf

Thymoma: A multivariate analysis of factors predicting survival

https://www.annalsthoracicsurgery.org/article/0003-4975(91)90478-9/pdf

Thymoma: results of 241 operated cases.

https://www.annalsthoracicsurgery.org/article/S0003-4975(96)00376-1/pdf

Extended thymectomy for myasthenia gravis patients: a 20-year review.

https://www.annalsthoracicsurgery.org/article/S0003-4975(10)62558-1/pdf

Recurrence of Thymoma: Clinicopathological Features, Therapy, and Prognosis

Effects of Preoperative Duration of Symptoms on Patients with Myasthenia Gravis

https://www.annalsthoracicsurgery.org/article/S0003-4975(10)62667-7/pdf

Yasumasa Monden

Papers

Extended thymectomy for myasthenia gravis patients: a 20-year review.

Recurrence of Thymoma: Clinicopathological Features, Therapy, and Prognosis

Effects of Preoperative Duration of Symptoms on Patients with Myasthenia Gravis

Clinical Characteristics and Prognosis of Myasthenia Gravis with Other Autoimmune Diseases

Myasthenia gravis in elderly patients.