The ITMIG/IASLC Thymic Epithelial Tumors Staging Project: A Proposed Lymph Node Map for Thymic Epithelial Tumors in the Forthcoming 8th Edition of the TNM Classification of Malignant Tumors

Abstract

Although the presence of nodal disease is prognostic in thymic malignancy, the significance of the extent of nodal disease has yet to be defined. Lymph node dissection has not been routinely performed, and there is currently no node map defined for thymic malignancy. To establish a universal language for reporting as well as characterize the staging of this disease more accurately, an empiric node map is proposed here. This was developed using prior classification systems, series reporting specifics of nodal involvement, anatomical studies of lymphatic drainage, and preexisting node maps of the chest as defined by the International Association for the Study of Lung Cancer and the neck as defined by the American Academy of Otolaryngology-Head and Neck Surgery and the American Society for Head and Neck Surgery. The development of this node map was a joint effort by the International Thymic Malignancy Interest Group and the Thymic Domain of the IASLC Staging and Prognostic Factors Committee. It was reviewed and subsequently approved by the members of ITMIG. This map will be used as an adjunct to define node staging as part of a universal stage classification for thymic malignancy. As more data are gathered using definitions set forth by this node map, a revision may be undertaken in the future.

Tumor location may affect the clinicopathological features and prognosis of thymomas

“…The International Association for the Study of Lung Cancer (IASLC) Staging Prognostic Factors Committee and International Thymic Malignancy Interest Group (ITMIG) recently proposed a staging system for thymomas and thymic carcinomas (TCs) that was in accordance with their survival outcomes . This staging system was approved for the eighth edition of the tumor, nodes, and metastasis (TNM) staging classification by the American Joint Committee on Cancer (AJCC) / the Union for International Cancer Control (UICC) consortium . Despite their extensive use, both the Masaoka‐Koga and the TNM staging systems have ambiguities that have not been confirmed.…”

“…16 This staging system was approved for the eighth edition of the tumor, nodes, and metastasis (TNM) staging classification by the American Joint Committee on Cancer (AJCC) / the Union for International Cancer Control (UICC) consortium. [16][17][18] Despite their extensive use, both the Masaoka-Koga and the TNM staging systems have ambiguities that have not been confirmed. Although thymomas can occur in any location of the anterior mediastinum, differences based on their anatomical tumor location have not been described in either of the current staging systems.…”

Combination of IL-6, IL-10, and MCP-1 with traditional serum tumor markers in lung cancer diagnosis and prognosis

“…The global mortality rate of lung cancer is rapidly rising; currently, China has the highest incidence and mortality rates of lung cancer, with an increasing number of younger patients being affected as compared to the past 20 years (Bhora et al, 2014;Burns and Stabile, 2014;Genestreti et al, 2014). The onset and development of lung cancer are driven by multiple factors, which are the result of various signaling pathways controlled by an array of genetic mutations.…”

Precision medicine in myasthenia graves: begin from the data precision

“…The role of thymus in the pathogenesis of MG is becoming more prominent and the value of repeated surgery to treat MG is under great attention (80). Fortunately, the standard thymus protocols developed by the International Thymic Malignancy Interest Group provide detailed CDEs of thymus (81)(82)(83)(84)(85)(86) and may lend their strength to MG researches.…”