Sandbox Thymoma staging: Difference between revisions
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|+ <SMALL>''Clinical | |+ <SMALL>''Clinical Staging by Bergh (1978) and Wilkins (1979)''<ref name="Bergh-1978">{{Cite journal | last1 = Bergh | first1 = NP. | last2 = Gatzinsky | first2 = P. | last3 = Larsson | first3 = S. | last4 = Lundin | first4 = P. | last5 = Ridell | first5 = B. | title = Tumors of the thymus and thymic region: I. Clinicopathological studies on thymomas. | journal = Ann Thorac Surg | volume = 25 | issue = 2 | pages = 91-8 | month = Feb | year = 1978 | doi = | PMID = 626543 }}</ref><ref name="Wilkins-1979">{{Cite journal | last1 = Wilkins | first1 = EW. | last2 = Castleman | first2 = B. | title = Thymoma: a continuing survey at the Massachusetts General Hospital. | journal = Ann Thorac Surg | volume = 28 | issue = 3 | pages = 252-6 | month = Sep | year = 1979 | doi = | PMID = 485626 }}</ref></SMALL> | ||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 100px;" | '''Author''' | ! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 100px;" | '''Author''' | ||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 15px;" | '''Stage''' | ! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 15px;" | '''Stage''' | ||
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| align=center | '''III''' ||Invasive growth into the surrounding organs and/or intrathoracic metastases | | align=center | '''III''' ||Invasive growth into the surrounding organs and/or intrathoracic metastases | ||
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==TNM Staging (1999)== | ==TNM Staging (1999)== | ||
Revision as of 22:08, 28 February 2014
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Thymoma Microchapters |
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Diagnosis |
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Case Studies |
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Sandbox Thymoma staging On the Web |
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American Roentgen Ray Society Images of Sandbox Thymoma staging |
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Risk calculators and risk factors for Sandbox Thymoma staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]
Overview
Staging of thymic epithelial tumors was initially proposed by Bergh and his colleagues in 1978,[1] modified by Wilkins and Castleman in 1979,[2] and advanced by Masaoka et al. in 1981 and became widely adopted.[3][4] In 1999, World Health Organization (WHO) proposed
- 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
| Stage | Description |
|---|---|
| I | Macroscopically completely encapsulated and microscopically no capsular invasion |
| II1 | Macroscopic invasion into surrounding fatty tissue or mediastinal pleura |
| II2 | Microscopic invasion into capsule |
| III | Macroscopic invasion into neighboring organ, ie, pericardium, great vessels, or lung |
| IVa | Pleural or pericardial dissemination |
| IVb | Lymphogenous or hematogenous metastasis |
| Author | Stage | Description |
|---|---|---|
| Bergh et al. | I | Intact capsule or growth within the capsule |
| II | Pericapsular growth into the mediastinal fat tissue | |
| III | Invasive growth into the surrounding organs and/or intrathoracic metastases | |
| Wilkins et al. | I | Intact capsule or growth within the capsule |
| II | Pericapsular growth into the mediastinal fat tissue or adjacent pleura or pericardium | |
| III | Invasive growth into the surrounding organs and/or intrathoracic metastases |
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.[5]
References
- ↑ 1.0 1.1 Bergh, NP.; Gatzinsky, P.; Larsson, S.; Lundin, P.; Ridell, B. (1978). "Tumors of the thymus and thymic region: I. Clinicopathological studies on thymomas". Ann Thorac Surg. 25 (2): 91–8. PMID 626543. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 Wilkins, EW.; Castleman, B. (1979). "Thymoma: a continuing survey at the Massachusetts General Hospital". Ann Thorac Surg. 28 (3): 252–6. PMID 485626. Unknown parameter
|month=ignored (help) - ↑ 3.0 3.1 Masaoka, A.; Monden, Y.; Nakahara, K.; Tanioka, T. (1981). "Follow-up study of thymomas with special reference to their clinical stages". Cancer. 48 (11): 2485–92. PMID 7296496. Unknown parameter
|month=ignored (help) - ↑ Kondo, K. (2005). "Invited commentary". Ann Thorac Surg. 80 (6): 2000–1. doi:10.1016/j.athoracsur.2005.08.053. PMID 16305832. Unknown parameter
|month=ignored (help) - ↑ 5.0 5.1 "Thymectomy and malignancy. [Eur J Cardiothorac Surg. 1994] - PubMed - NCBI".