TNM Staging System in Thymoma: A Critical Appraisal?
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. T-Factor
3.2. N-Factor
3.3. M-Factor
4. Discussion
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Stages | Description |
---|---|
Stage I | Grossly and microscopically completely encapsulated tumor |
Stage IIa | Microscopic transcapsular invasion |
Stage IIb | Macroscopic invasion into thymic or surrounding fatty tissue, or grossly adherent to but not breaking through mediastinal pleura or pericardium |
Stage III | Macroscopic invasion into neighboring organ (i.e., pericardium, great vessel, or lung) |
Stage IVa | Pleural or pericardial metastases |
Stage IVb | Lymphogenous or hematogenous metastasis |
Category | Definition * | ||
---|---|---|---|
T1a | Encapsulated or unencapsulated, with or without extension into mediastinal fat | ||
T1b | Extension into mediastinal pleura | ||
T2 | Pericardium | ||
T3 | Lung, brachiocephalic vein, superior vena cava, chest wall, phrenic nerve, hilar (extrapericardial) pulmonary vessels | ||
T4 | Aorta, arch vessels, main pulmonary artery, myocardium, trachea, or esophagus | ||
N0 | No nodal involvement | ||
N1 | Anterior (perithymic) nodes | ||
N2 | Deep intrathoracic or cervical nodes | ||
M0 | No metastatic pleural, pericardial, or distant sites | ||
M1a | Separate pleural or pericardial nodule(s) | ||
M1b | Pulmonary intraparenchymal nodule or distant organ metastasis | ||
Stage | T | N | M |
I | T1 | N0 | M0 |
II | T2 | N0 | M0 |
IIIa | T3 | N0 | M0 |
IIIb | T4 | N0 | M0 |
IVa | T any | N1 | M0 |
T any | N0, 1 | M1a | |
IVb | T any | N2 | M0, 1a |
T any | N any | M1b |
Parameter | Description |
---|---|
T1 | Tumor limited to the thymus with or without encapsulation, or directly invades into the mediastinum alone, or directly invades the mediastinal pleura but does not involve any other mediastinal structure. |
T1a | 5 cm or less in its greatest dimension * |
T1b | larger than 5 cm in its greatest dimension * |
T2 | Tumor directly invades the pericardium (either partial or full thickness), or the lung or the phrenic nerve |
T3 | Tumor directly invades any of the following: (1) brachiocephalic vein, (2) superior vena cava, (3) chest wall or (4) extrapericardial pulmonary arteries or veins |
T4 | Tumor directly invades any of the following: (1) aorta (ascending, arch, or descending), (2) arch vessels, (3) intrapericardial pulmonary artery or veins, (4) myocardium, (5) trachea, or (6) esophagus |
N0 | No nodal involvement |
N1 | Anterior (peri thymic) nodes |
N2 | Deep intrathoracic or cervical nodes (e.g., paratracheal, subcarinal, aortopulmonary window, hilar, jugular, and supraclavicular nodes) |
M0 | No metastatic pleura, pericardial or distant sites |
M1a | Separate pleural or pericardial nodule(s) |
M1b | Pulmonary intra-paranchimal nodule or distant organ metastasis |
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Ambrogi, M.C.; Aprile, V.; Lenzini, A.; Bacchin, D.; Mastromarino, M.G.; Korasidis, S.; Lucchi, M. TNM Staging System in Thymoma: A Critical Appraisal? J. Clin. Med. 2024, 13, 610. https://doi.org/10.3390/jcm13020610
Ambrogi MC, Aprile V, Lenzini A, Bacchin D, Mastromarino MG, Korasidis S, Lucchi M. TNM Staging System in Thymoma: A Critical Appraisal? Journal of Clinical Medicine. 2024; 13(2):610. https://doi.org/10.3390/jcm13020610
Chicago/Turabian StyleAmbrogi, Marcello Carlo, Vittorio Aprile, Alessandra Lenzini, Diana Bacchin, Maria Giovanna Mastromarino, Stylianos Korasidis, and Marco Lucchi. 2024. "TNM Staging System in Thymoma: A Critical Appraisal?" Journal of Clinical Medicine 13, no. 2: 610. https://doi.org/10.3390/jcm13020610