Thymectomy for non-thymomatous XXXX : a propensity score matched study.

@entity1 @entity1737
UNASSIGNED: BackgroundThe efficacy of thymectomy in @entity1 with non-thymomatous @entity1737 ( @entity1737 ) is still unclear. Main limitations have been variable outcome definitions, lack of a control group and adjustment for confounding.ObjectiveTo study the efficacy of thymectomy in achieving remission or minimal manifestation (R/MM) status in @entity1 with non-thymomatous @entity1737 .MethodsPatients with generalized @entity1737 and minimum follow-up of 6  months were included. Demographic data and treatments were recorded, as well as the MGFA post-intervention status at the last visit. Propensity scores were used to create a matched cohort of treated and untreated @entity1 . Standard and Bayesian Cox models were used to study treatment effects.ResultsOf 395 @entity1 included, 183(46%) had a thymectomy. Thymectomy @entity1 were younger (p  <  0.001), with more females (p  <  0.001) and more @entity1 in MGFA classes 4  5 at diagnosis (p  =  0.01). A matched cohort of thymectomized @entity1 and controls (n  =  98) was created. The hazard ratio (HR) for the matched cohort was 1.9 (CI:1.6-2.3), favoring thymectomy. The predicted R/MM rate was 21% in treated and 6% in controls at 5  years (Absolute difference:15%). A Bayesian Cox model for the matched cohort had an estimated probability of thymectomy efficacy (HR  >  1) of 96% using a non-informative prior, and 79% using a skeptical prior.DiscussionWhen controlling for potential confounders, thymectomized @entity1 had a higher probability of achieving R/MM status through time compared to controls. This study provides class III evidence of the efficacy of thymectomy in non-thymomatous @entity1737 .
