Thymoma staging: Difference between revisions
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==Overview== | ==Overview== | ||
*There is no universally accepted system; no AJCC staging exists. | |||
*Historically, a classifiaction system used both histological features and clinical behavior. | |||
*Masaoka staging is the clinically used staging system, although it may not be predictive for thymic carcinoma. | |||
*GETT staging is the surgical staging system, and may have better correlation with outcome. | |||
*A meta-analysis from UCLA suggests that evaluation of transcapsular extension (Stage I vs. Stage IIa) is of no clinical value, as they have same DFS and OS outcomes. | |||
== | ==Historical Classification== | ||
*Benign Thymoma (histologically and behaviorally benign) | |||
*Malignant Thymoma (invasive) | |||
:*Type I - histologically benign, but behaving aggressively with local invasion | |||
:*Type II ("thymic carcinoma") - histologically malignant, aggresive behavior | |||
*I | ==Masaoka TNM Staging (1999)== | ||
* | {| | ||
| [[File:T010.png|800px|thumb]] | |||
*III | |} | ||
*IVA | |||
*IVB | ==Original Masaoka Staging (1991)== | ||
*Stage I - Macroscopically and microscopically completely encapsulated | |||
*Stage II - Macroscopic invasion into surrounding fatty tissues or mediastinal pleura or microscopic invasion into the capsule | |||
*Stage III - Macroscopic invasion into adjacent organs or intrathoracic metastases | |||
*Stage IVA - Pleural or pericardial implants/dissemination | |||
*Stage IVB - Nodal or hematogenous metastases | |||
==GETT Staging== | |||
*Stage IA - Encapsulated, completely resected. | |||
*Stage IB - Macroscopically completely resected but suspicion of mediastinal adhesions or potential capsular invasion at surgery. | |||
*Stage II - Invasive tumor, completely resected. | |||
*Stage IIIA - Invasive tumor, subtotal resection. | |||
*Stage IIIB - Invasive tumor, biopsy alone. | |||
*Stage IVa - Supraclav or pleural met. | |||
*Stage IVb - Distant metastases.<ref>{{Cite web | last = | first = | title = Radiation Oncology/Thymoma/Staging - Wikibooks, open books for an open world | url = http://en.wikibooks.org/wiki/Radiation_Oncology/Thymoma/Staging | publisher = | date = | accessdate = }}</ref> | |||
==References== | ==References== | ||
Revision as of 21:32, 19 February 2014
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Thymoma Microchapters |
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Diagnosis |
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Case Studies |
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Thymoma staging On the Web |
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American Roentgen Ray Society Images of Thymoma staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]
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Overview
- There is no universally accepted system; no AJCC staging exists.
- Historically, a classifiaction system used both histological features and clinical behavior.
- Masaoka staging is the clinically used staging system, although it may not be predictive for thymic carcinoma.
- GETT staging is the surgical staging system, and may have better correlation with outcome.
- A meta-analysis from UCLA suggests that evaluation of transcapsular extension (Stage I vs. Stage IIa) is of no clinical value, as they have same DFS and OS outcomes.
Historical Classification
- Benign Thymoma (histologically and behaviorally benign)
- Malignant Thymoma (invasive)
- Type I - histologically benign, but behaving aggressively with local invasion
- Type II ("thymic carcinoma") - histologically malignant, aggresive behavior
Masaoka TNM Staging (1999)
 |
Original Masaoka Staging (1991)
- Stage I - Macroscopically and microscopically completely encapsulated
- Stage II - Macroscopic invasion into surrounding fatty tissues or mediastinal pleura or microscopic invasion into the capsule
- Stage III - Macroscopic invasion into adjacent organs or intrathoracic metastases
- Stage IVA - Pleural or pericardial implants/dissemination
- Stage IVB - Nodal or hematogenous metastases
GETT Staging
- Stage IA - Encapsulated, completely resected.
- Stage IB - Macroscopically completely resected but suspicion of mediastinal adhesions or potential capsular invasion at surgery.
- Stage II - Invasive tumor, completely resected.
- Stage IIIA - Invasive tumor, subtotal resection.
- Stage IIIB - Invasive tumor, biopsy alone.
- Stage IVa - Supraclav or pleural met.
- Stage IVb - Distant metastases.[1]