Objective: We performed propensity score (PS) models to compare the outcome of patients with myasthenia gravis (MG) submitted to 2 different surgical approaches: extended transsternal (T-3b) or thoracoscopic extended thymectomy (VATET). Methods: Patients' clinical data were retrieved from the MG database of the C. Besta Neurologic Institute Foundation. In the PS analysis, a matching ratio of 1:1 of the main clinical variables was obtained for the 2 groups of patients and treatment effect was estimated by comparing their outcome. Results: A total of 210 patients met the inclusion criteria, by having a complete set of clinical data, and were included in the PS model; a matched dataset of 122 participants (61 per group) showed an adequate balance of all the covariates. Our analysis demonstrated that 68.9% of patients who had thymectomy by the VATET technique reached the pharmacologic remission/remission status at 2 years from thymectomy compared to 34.4% of those operated on by the T-3b technique (p < 0.001), had a lower INCB-MG score (p < 0.001), and had less muscle fatigability (p = 0.004). Similar results were found considering only nonthymomatous patients with MG. Results were also confirmed by paired statistical tests. Conclusions: Our PS matching analysis showed that VATET is a reliable and effective surgical approach alternative to T-3b in patients with MG who are candidates for thymectomy. Classification of evidence: This study provides Class IV evidence that for patients with MG, VATET is more effective than T-3b thymectomy.
Brenna, G., Antozzi, C., Montomoli, C., Baggi, F., & Mantegazza, R. (2017). A propensity score analysis for comparison of T-3b and VATET in myasthenia gravis. NEUROLOGY, 89(2), 189-195.
|Citazione:||Brenna, G., Antozzi, C., Montomoli, C., Baggi, F., & Mantegazza, R. (2017). A propensity score analysis for comparison of T-3b and VATET in myasthenia gravis. NEUROLOGY, 89(2), 189-195.|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||A propensity score analysis for comparison of T-3b and VATET in myasthenia gravis|
|Autori:||Brenna, G; Antozzi, C; Montomoli, C; Baggi, F; Mantegazza, R|
|Data di pubblicazione:||2017|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1212/WNL.0000000000004082|
|Appare nelle tipologie:||01 - Articolo su rivista|