ArticleEuropean journal of neurology2025
Robotic Extended Thymectomy in Late-Onset Myasthenia Gravis: A 21-Year Retrospective Cohort Study of 172 Patients.
Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- A comparison study of thymectomy outcomes in young and older patients with non-thymomatous myasthenia gravis.Journal of neurology · 2026Article
- Robotic Extended Thymectomy in Late-Onset Myasthenia Gravis: A 21-Year Retrospective Cohort Study of 172 Patients.European journal of neurology · 2025Article
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Authors and funding
16 authors.
Funding
Abstract
backgroundThe safety and feasibility of robotic-assisted (RATS) thymectomy for myasthenia gravis (MG) with onset age ≥ 50 years remain unverified, particularly in very late-onset MG (V-LOMG).
methodsPatients were classified into late-onset MG (LOMG, 50-64) and very late-onset MG (V-LOMG ≥ 65) based on age of onset. Composite neurological remission (CNR) included complete stable remission (CSR), pharmacologic remission (PR), and minimal manifestations-0 (MM-0), while favorable outcomes comprised CNR and MM1-3.
resultsAmong 1041 patients, 172 with MG onset at ≥ 50 years who underwent RATS extended thymectomy were included in the final analysis. The LOMG group comprised 104 patients (45.2% male), while the V-LOMG group included 68 patients (60.3% male). V-LOMG patients had more preoperative MG crises, shorter onset-to-thymectomy intervals, heavier thymic specimens, and less hyperplasia. In ocular-onset MG, generalization was more frequent in LOMG than in V-LOMG. No significant differences were found in other baseline characteristics, perioperative parameters, postoperative complications, and adverse composite outcomes. At a 5.1-year mean follow-up, the V-LOMG group had slightly higher CSR (7.4% vs. 6.7%), CNR (16.2% vs. 11.5%), and favorable outcome rates (52.9% vs. 45.2%) than the LOMG group, with no statistical significance. Both groups, especially V-LOMG (16.0 mg vs. 2.1 mg, p < 0.001), showed a significant corticosteroid dose reduction at the last follow-up, confirming the steroid-sparing effect of thymectomy.
conclusionsRATS extended thymectomy appears to be a safe and feasible treatment for patients with MG of onset at age ≥ 50 years, including those with V-LOMG, demonstrating a significant steroid-sparing effect while maintaining favorable neurological outcomes.
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