Thymoma staging
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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]
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)
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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]