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Table 1 Demographic data of studies selected for this review

From: Thymectomy in nonthymomatous myasthenia gravis - systematic review and meta-analysis

Author/Year (period) country Study design Surgical total (female, male) Medical total (female, male) Remission Improvement Follow-up Medical treatment
Surgical Medical Surgical Medical
Wolfe/2016 [14]
(2006–2012)
36 centers, 32 in USA
Multicenter
RCT
66 (50,16) 60 (39,21)    Average MG score 6.15 Average MG score 8.99 3 years Predinisone
Barnett/2014 [17] (2000–2013) Canada Single center Retrospective
Unmatched (U) matched (M)
U- 183 (124,59)
M- 49 (25, 24)
U- 212 (89, 123)
M- 49 (27, 22)
R/MMa
U-40 (22%)
M−10(21%)
R/MMa
U-49 (23%) M− 3(06%)
   60 months Prednisone
Bachmann/2009 [18]
(1980–2005)
Germany
Single center Retrospective 84 (56, 28) 88 (50, 38) 35 (42%) 12 (14%) 32 (38%) 15 (17%) Mean = 10 years Pyridostigmine/azathioprine/glucocorticoids/ plasmapheresis
Al-Moalen/2008 [19]
(1984–2006)
Saudi Arabia
Single center Retrospective 73 (49, 24) 23 (13, 10) 10 (14%) 0 24 (33%) 6 (26%) Mean = 7.2 years Pyridostigmine/prednisolone/azathioprine
Tsinzerling/2007 [20]
(1956–2006)
Sweden
Single center Retrospective 261 (179,82) 211 (105,106) 77 (29.5%) 32 (15%) 139 (53%) 142 (67%) > 1.5 year Azathioprine/cyclosporine/steroids
Kawaguchi/2007 [21]
(1999–2000)
Japan
Multicenter Retrospective 20 (10, 10) 14 (11, 3) 6 (30%) 3 (21%) 10 (50%) 8 (57%) 11.7 years (surgical)
7.8 years (non-surgical)
Cholinesterase inhibitors/corticosteroids/other immunosuppressive agents
Werneck/2000 [22] (1973–1995) Brazil Single center Retrospective matched 28 (20, 8) 28 (20, 8) 6 (21%) 9 (32%) 8 (29%) 1 (4%) Mean
Surgical = 6.3 years
Non-surgical = 3.5 years
Prednisolone/ cholinesterase
Inhibitors/ immunosuppressive
agents
Lorenzana/1999 [23]
(1991–1995)
Colombia
Single center RCT 11 (10, 1) 18 (16, 2) Fatigue gain 9.1 s. Fatigue gain 2.2 s. Strength 2.1 Strength 0.25 2 years Prednisolone/pyridostigmine/prostigmine
Robertson/1998 [24] (1965–1997) UK Single center Retrospective 22 (21,1) 41 (27,14) 6 (27%) 3 (7%) 12 (55%) 15 (37%) Not reported Anticholinesterase/steroids/azathioprine/plasmapheresis
Evoli/1998 [25] (not informed) Italy Single center Retrospective matched 45 (35,10) 20 (14,6) 15 (33%) 2 (10%) Not reported Not reported ≥ 3 years cholinesterase
Inhibitors/ immunosuppressive
Agents/corticosteroids
Mantegazza/1990 [26] (not informed) Italy Multicenter Retrospective 555 (not reported) 313 (not reported) 84 (15%) 19 (6%) 160 (29%) 56 (18%) Mean = 4,9 years Glucocorticoids/imunossupressive agents/ plasmapheresis
Donaldson/1990 [27]
(1975–1988)
USA
Single center Retrospective 90 57 23 (26%) 5 (9%) 30 (33%) 11 (19%) Mean 8 years Prednisolone/pyridostigmine/azathioprine/cyclophosphamide/ plasmapheresis
Valli/1987 [28] (1973–1985) Italy Single center Retrospective 63 28 22 (35%) 2 (7%) 28 (44%) 19 (68%) 2–12 years Cholinesterase inhibitors/corticosteroids/azathioprine
Papatestas/1987 [29]
(1951–1985)
USA
Single center Retrospective 788 (not reported) 1048 (not reported) 181 (23%) 146 (14%) Not reported Not reported Not reported Not reported
Assis/1987 [30]
(not informed) Brazil
Single center Retrospective 19 (17, 2) 14 (12, 2) 6 (32%) 3 (21%) 12 (63%) 10 (71%) 8–24 years Anticolinesterasic
Oosterhius/1981 [31]
(1960–1980)
The Netherlands
Single center Retrospective 144 183 39 (27%) 34 (19%) Not reported Not reported 10.2 years (surgical)
16.8 years (non-surgical)
Cholinesterase inhibitors/corticosteroids/azathioprine
Emeryk/1976 [32]
(1963–1973) Poland
Single center Retrospective 112 (90,22) 75 (52,23) 26 (23%) 7 (9%) 70 (62%) 35 (47%) Mean 3 years Cholinesterase inhibitors
Buckingham/1976 [33] (?-65) USA Single center Retrospective matched 80 (64,16) 80 (64,16) 27 (34%) 6 (7.5%) 26 (32%) 13 (16%) 19.5 years (surgical)
23 years (non-surgical)
Not reported
Perlo/1971 [34]
(?)
USA
Multicenter Retrospective 267 (217,50) 417 (?) 92 (34%) 71 (17%) 109 (41%) 46 (11%) 1–28 years Edrophonium chloride/neostigmine
Total   2911 2930       
  1. aR/MM- Remission or minimal manifestation