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      Clinical TNM staging of thymic epithelial malignancies

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      Publication date (Electronic):
      Journal: Mediastinum
      Publisher: AME Publishing Company
      Keywords: TNM stage classification, thymic epithelial tumors (TETs), thymoma, thymic carcinoma

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          Abstract

          The International Thymic Malignancy Interest Group (ITMIG) and the International Association for the Study of Lung Cancer (IASLC) formed the Thymic Domain of the Staging and Prognostic Factors Committee (TD-SPFC) to develop the first stage classification system for thymic epithelial tumors (TETs) which was published in the TNM Classification of Malignant Tumours issued by the American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC), now in 8th edition. This system was developed from evidence-based analysis of the large ITMIG database of TETs, in conjunction with expert opinion. Until its publication in December 2017, there had been no universally accepted, standard means of classifying these tumors, although Masaoka-Koga staging system had most closely approached this standard. This brief article will summarize this new stage classification system for TETs, highlighting its differences with Masaoka-Koga and relevant next goals.

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          The IASLC/ITMIG Thymic Epithelial Tumors Staging Project: proposal for an evidence-based stage classification system for the forthcoming (8th) edition of the TNM classification of malignant tumors.

          Frank C Detterbeck, Kelly Stratton, Dorothy Giroux … (2014)
          A universal and consistent stage classification system, which describes the anatomic extent of a cancer, provides a foundation for communication and collaboration. Thymic epithelial malignancies have seen little progress, in part because of the lack of an official system. The International Association for the Study of Lung Cancer and the International Thymic Malignancies Interest Group assembled a large retrospective database, a multispecialty international committee and carried out extensive analysis to develop proposals for the 8th edition of the stage classification manuals. This tumor, node, metastasis (TNM)-based system is applicable to all types of thymic epithelial malignancies. This article summarizes the proposed definitions of the T, N, and M components and describes how these are combined into stage groups. This represents a major step forward for thymic malignancies.
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            Follow-up study of thymomas with special reference to their clinical stages

            Akira Masaoka, Yasumasa Monden, Kazuya Nakahara … (1981)
            Article 0 comments Cited 117 times – based on 0 reviews     Review now
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              A review of 79 thymomas: modification of staging system and reappraisal of conventional division into invasive and non-invasive thymoma.

              Kenji Koga, Yoshihiro Matsuno, Masayuki Noguchi … (1994)
              A clinicopathological study of surgically resected thymomas was performed using Masaoka's staging and modified Masaoka's staging systems, and the utility of these two staging systems was compared. The modification enabled adjustment for the disproportion in the number of cases between Stage I and Stage II. Analysis of survival rates, according to the tumor stage, indicated that the old classification should be reappraised, that is, division into non-invasive and invasive thymomas, although staging may contribute to the indication for postoperative radiotherapy, especially for Stage II disease. Analysis of the cases showed a wide spectrum of aggressiveness, varying from cases showing slow progression with a relatively favorable prognosis, such as the spindle cell type, to cases with rapid progression leading to tumor death in a relatively short time, such as the epithelial cell predominant and polygonal cell type. The pathological stage at the time of first surgical resection would reflect the degree of aggressiveness of thymoma in many instances. Therefore, not only staging the tumor extent but also grading of its aggressiveness are needed in order to predict the prognosis of patients with thymoma. For the latter, histology and cytopathology are helpful.
              Article 0 comments Cited 115 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Mediastinum
                Journal ID (iso-abbrev): Mediastinum
                Journal ID (publisher-id): MED
                Title: Mediastinum
                Publisher: AME Publishing Company
                ISSN (Electronic): 2522-6711
                Publication date (Electronic): 20 February 2019
                Publication date Collection: 2019
                Volume: 3
                Electronic Location Identifier: 5
                Affiliations
                [1]deptDivision of Thoracic Imaging and Intervention , Massachusetts General Hospital , Boston, MA, USA
                Author notes
                Correspondence to: Jeanne B. Ackman, MD, FACR. Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. Email: jackman@ 123456mgh.harvard.edu .
                Article
                Publisher ID: med-03-5
                DOI: 10.21037/med.2019.01.04
                PMC ID: 8794289
                PubMed ID: 35118234
                SO-VID: 52c0fc32-0d37-4626-a9ee-7abd4e13182d
                Copyright © 2019 Mediastinum. All rights reserved.
                License:

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

                History
                Date received : 13 January 2019
                Date accepted : 27 January 2019
                Categories
                Subject: Mini-Review

                Keywords: tnm stage classification,thymic epithelial tumors (tets),thymoma,thymic carcinoma
                Data availability:
                Keywords: tnm stage classification, thymic epithelial tumors (tets), thymoma, thymic carcinoma

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