Criteria
The Masaoka-Koga staging system has been widely used to characterize thymoma tumor stage. However, the 8th edition of the American Joint Committee on Cancer (AJCC) TNM staging system for malignant tumors introduced a TNM classification for thymic malignancies.[29] This classification system was jointly developed by the International Thymic Malignancy Interest Group (ITMIG) and the International Association for the Study of Lung Cancer (IASLC), using a global database of over 10,000 cases.
Masaoka-Koga staging system[33][34][35]
Based on anatomic extent of thymoma at the time of surgery
Stage I: encapsulated tumor with no evidence of invasion
Stage IIA: microscopic transcapsular invasion (into the surrounding mediastinal fat)
Stage IIB: macroscopic invasion into thymic or surrounding mediastinal fat; or adherent to, but not invading through, the mediastinal pleura or pericardium
Stage III: invasion into local structures (pleura, pericardium, lung, great vessels)
Stage IVA: pleural or pericardial dissemination
Stage IVB: hematogenous or lymphatic metastases.
American Joint Committee on Cancer (AJCC) 8th edition TNM staging classification[29]
The AJCC staging system describes the primary tumor (T stage), regional lymph nodes (N stage), and presence or absence of distant metastases (M stage).
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