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Vanessa Bolejack

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    PL04 - Food for Thought in the Management of Thoracic Malignancies (ID 91)

    • Event: WCLC 2019
    • Type: Plenary Session
    • Track: Advanced NSCLC
    • Presentations: 1
    • Now Available
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      PL04.03 - The Relevance of an International Database for the Study of Thymic Neoplasms (Now Available) (ID 3597)

      16:15 - 17:00  |  Presenting Author(s): Vanessa Bolejack

      • Abstract
      • Presentation
      • Slides



      Until the 8thedition of the AJCC/UICC TNM classification of malignant tumours went into effect, no official stage classification was available for thymic malignancies. Some classification systems had been proposed but were generally developed from a limited number of patients and not usually tested in an independent dataset. The system developed by Dr. Akira Masaoka in 1981 did undergo external validation and was widely adopted. However, the adoption of these proposed systems in different institutions and regions was hampered by a lack of uniform nomenclature and varying interpretations of definitions. The current (8thedition) TNM stage classification for thymic malignancies endorsed by AJCC and UICC was informed by a database with 10,808 cases of thymic malignancies from 105 sites worldwide, compiling cases contributed by ITMIG (including patients from North and South America, European, and Korean (KART) and Chinese (ChART) institutions), Japan (JART), and Europe (ESTS) with funding and coordination by IASLC and Cancer Research and Biostatistics (CRAB), with the specific intent of developing a TNM based staging system for these malignancies.

      Methods and materials

      The IASLC Stating and Prognostic Factors Committee - Thymic Domain (SPFC-TD) conducted a web-based cross-sectional survey to assess the implementation of the 8thEdition TNM staging system in the thoracic community. The survey was sent to the major thymic organizations (ITMIG, ESTS, KART, ChART, RYTHMIC, JART) in addition to IASLC membership. A new database to inform the 9thedition TMN staging system is under development to provide updated follow-up from the institutions contributing to the 8thedition database, add additional institutions, and add new cases collected prospectively.


      According to the survey results, the TNM stage classification of thymic tumors has gained a reasonable acceptance in the scientific community, while the Masaoka stage system remains widely employed. An increased attention to the N descriptor seems to have been incorporated. There is high awareness of the new staging system. The current efforts of the Thymic Domain of the IASLC Staging and Prognostic Factors Committee focus on expanding and updating the database used for the 8thedition to further refine the stage definitions and includes updated follow-up on patients from Turkey, the ESTS, JART, ChART and KART, plus data collected prospectively from ChART.


      The database created to inform the 9thedition of TNM staging for thymic malignancies will allow for refinement and adjustment of the 8thedition system and attempt to address any perceived deficiencies of the current system. An overview of the current state of the database will be presented at the meeting in Barcelona.

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