ArticleMediastinum (Hong Kong, China)2021
Impact of the TNM staging system for thymoma.
Article in Mediastinum (Hong Kong, China), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Evolving paradigms in thymoma surgery and multidisciplinary care: a narrative review.Mediastinum (Hong Kong, China) · 2026Review
- Prognostic and predictive biomarkers in thymic epithelial tumors: beyond traditional staging: a narrative review.Mediastinum (Hong Kong, China) · 2026Review
- Advanced thymic epithelial tumour resection: vascular resection and reconstruction strategy.Journal of thoracic disease · 2025Article
- Surgical management of thymic tumors: a narrative review with focus on robotic-assisted surgery.Mediastinum (Hong Kong, China) · 2024Review
- Prognostic factors and genetic markers in thymic epithelial tumors: A narrative review.Thoracic cancer · 2022Review
- The Studies of Prognostic Factors and the Genetic Polymorphism of Methylenetetrahydrofolate Reductase C667T in Thymic Epithelial Tumors.Frontiers in oncology · 2022Article
- Stage-specific biomarkers in triple-negative breast cancer: Preliminary findings from bioinformatics approaches.Cancer biomarkers : section A of Disease markersArticle
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMasaoka-Koga staging system remains the most frequently applied clinical staging system for thymic malignancy. However, the International Association for the Study of Lung Cancer (IASLC)/International Thymic Malignancy Interest Group (ITMIG) proposed a tumor-node-metastasis (TNM) staging system in 2014. This study aims to evaluate its impact on stage distribution, clinical implementation, and prognosis for thymomas.
methodsWe performed a single institution, retrospective analysis of 245 consecutive patients who underwent surgical resection for thymoma. 9 patients with thymic carcinoma were excluded. No patients were lost to follow up. Kaplan-Meier survival analysis was used to calculate overall survival.
resultsMedian age was 62 years; 129 patients (53%) were female. The median overall survival was 158 months (range, 108-208 months), and disease-free survival 194 months (range, 170-218 months). At the end of follow up 63 patients were dead. Early Masaoka-Koga stages I (n=74) and II (n=129) shifted to the IASLC/ITMIG stage I (n=203). 8 patients were down staged from Masaoka-Koga stage III to IASLC/ITMIG stage II because of pericardial involvement. Advanced stages III (Masaoka-Koga: n=30; IASLC/ITMIG: n=22) and IV (Masaoka-Koga: n=12; IASLC/ITMIG: n=12) remained similar and were associated with more aggressive WHO thymoma histotypes (B2/B3). Masaoka-Koga (P=0.004), IASLC/ITMIG staging (P<0.0001) and complete surgical resection (P<0.0001) were statistically associated with survival. At multivariate analysis only R status was an independent prognostic factor for survival.
conclusionsThe proportion of patients with stage I disease increased significantly when IASLC/ITMIG system used, whilst the proportion with stages III and IV were similar in both systems. Completeness of resection, Masaoka-Koga and the IASLC/ITMIG staging system are strong predictors of survival. The TNM staging system is useful in disease management and a strong predictor of overall survival.
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