{
  "abstract": "Objective\n\nTo characterize clinically significant myasthenia gravis (MG) relapse/exacerbation after thymoma resection and compare classification systems for risk stratification.Methods\n\nThis multicenter retrospective cohort included 257 patients with thymoma-associated MG who underwent extended thymectomy at 3 centers from July 2009 through November 2025. The end point was new MG symptoms after postoperative complete stable remission, pharmacologic remission, or minimal manifestation status plus verifiable MG-related treatment escalation or rescue therapy. Death without MG relapse/exacerbation was treated as a competing event. Cumulative incidence functions were estimated with Aalen-Johansen and compared with Gray tests; predictors were assessed with Fine-Gray models.Results\n\nDuring median follow-up of 41.6 months, 69 relapse/exacerbation events and 21 competing deaths occurred. Cumulative incidence was 20.4% at 3 years and 29.0% at 5 years; 68% and 90% of events occurred within 3 and 5 years, respectively. Among 52 relapse/exacerbation events in patients who underwent surgery in 2018 or later with retrievable treatment-status data, 28 (53.8%) occurred during ongoing immunosuppression and 24 (46.2%) after withdrawal. The a/b phenotype-based grouping of the Myasthenia Gravis Foundation of America classification (1/A/B) showed the strongest separation (3-year cumulative incidences, 2.5%, 12.3%, and 56.4%; 5-year cumulative incidences, 7.6%, 29.6%, and 56.4% for groups 1, A, and B). Groups A and B were independently associated with relapse/exacerbation (subdistribution hazard ratio, 2.65; 95% CI, 1.18-5.91; and 10.55; 95% CI, 4.55-24.47).Conclusions\n\nClinically significant MG relapse/exacerbation after thymoma resection clustered in the early postoperative years. The a/b phenotype-based grouping of the Myasthenia Gravis Foundation of America classification (1/A/B) provided the most informative risk stratification.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.",
    "Fujian Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, Fujian, China.",
    "State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.",
    "Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.",
    "Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Zhiheng Yao"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Hongmu Li"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Zhenyuan Yang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yu Huang"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Leqi Zhong"
    },
    {
      "affs": [
        4
      ],
      "name": "Zhenyu Zhao"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yiling Cai"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Chun Chen"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Bin Zheng"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0t1s5dx5p5zxj.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xjon.2026.101980",
  "fulltext_url": "https://europepmc.org/articles/PMC13711190",
  "id": "0t1s5dx5p5zxj",
  "issns": [
    "2666-2736"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948408",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Thoracic: Mediastinum"
    ],
    [
      "openalex",
      "2728|Myasthenia Gravis and Thymoma"
    ]
  ],
  "openalex": "W7203977765",
  "pdf_url": "https://europepmc.org/articles/PMC13711190?pdf=render",
  "pmcid": "PMC13711190",
  "pmid": "42948408",
  "published": "2026-08-22",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/0t1s5dx5p5zxj.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:35Z",
      "native_id": "MED:42948408",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948408"
    },
    {
      "first_seen": "2026-10-31T12:22:00Z",
      "native_id": "PMC13711190",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.xjon.2026.101980"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Myasthenia Gravis and Thymoma",
      "subfield": "neurology"
    }
  ],
  "title": "Comparison of the performance of clinical classification systems for myasthenia gravis relapse after thymoma resection.",
  "title_text": "Comparison of the performance of clinical classification systems for myasthenia gravis relapse after thymoma resection.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:00Z",
  "url": "https://research.draconitic.com/paper/0t1s5dx5p5zxj",
  "venue": "JTCVS open",
  "versions": []
}