Sandbox/thy02

Treatment of Thymoma and Thymic Carcinoma

Thymic Tumor

▸ Resectable

▸ Unresectable

Resectable

Resection of 1ry tumor & isolated metastasis

Consider postoperative radiotherapy

Locally advanced

Chemotherapy

Re-evaluate for surgery

Unresectable

Radiotherapy +/- chemotherapy

Chemotherapy

Thymoma

Isolated solitary metastasis

Surgery

Consider chemotherapy or radiotherapy

Evidence of distant metastasis

Chemotherapy

Pathology evaluation

R0 Resection

R2 Resection

R1 Resection

Thymoma, no capsular invasion or thymic carcinoma,stage I

Thymoma or thymic carcinoma, capsular invasion presents stages II-IV

Thymoma

Thymic carcinoma

Thymoma

Thymic carcinoma

Surveillance for recurrence with CT every 6 month for 2 y, then annually every 5 y for thymic carcinoma and 10 y for thymoma

Consider postoperative RT

Postoperative RT

Postoperative RT+chemotherapy

RT +/- chemotherapy

Surveillance for recurrence with CT every 6 month for 2 y, then annually every 5 y for thymic carcinoma and 10 y for thymoma

Relapse(check recurrence algorithm)