LONG-TERM OUTCOME AND QUALITY-OF-LIFE AFTER THYMECTOMY FOR MYASTHENIA-GRAVIS

Objective The authors identify criteria suitable to predict long-term clinical improvement and evaluate quality of life after thymectomy for myasthenia. Design Retrospective analysis with long-term follow-up (m ean 92 months) was conducted for 86 patients and questionnaire intervi ews were performed for 65 patients who underwent thymectomy between 19 76 and 1993. Main Outcome Measures The authors used the Osserman Score and the European Organization for Research and Treatment of Cancer qu ality-of-life questionnaire. Results After thymectomy, lasting benefit s were achieved predominantly by patients with moderate and severe mya sthenia, and this association was significant (p <0.001) in both bivar iable and multiple analyses. No correlation was observed between outco me and thymic pathology, patient age or gender, duration of disease, p reoperative plasmapheresis, and medication. Restitution to normal was complete at most recent follow-up as to physical status, working abili ty, and cognitive and social functions, but some emotional and vegetat ive deficits remained. Conclusion Future patient selection for thymect omy should-apart from those with suspected thymoma-concentrate on pati ents with moderate and severe myasthenia unresponsive to conservative management.