Standard Outcome Measures for Thymic Malignancies

Abstract

Thymic malignancies present particular issues due to the pace of disease progression, patterns of recurrence, and causes of death that make nuances of how outcomes are reported particularly important. The relatively limited number of patients also creates a challenge to glean as much as possible from the available experience, but risks over-interpretation and potentially misleading conclusions. Therefore the International Thymic Malignancy Interest Group has developed a set of standards for reporting of outcome measures of clinical studies, which have been adopted for collaborative projects undertaken by the organization. Widespread adoption of this baseline will enhance the ability to compare results from different series.

Importance of Lymph Node Dissection in Thymic Carcinoma

“…We adopted the definition of recurrence recommended by the International Thymic Malignancy Interest Group (Table 1) [11]. Duration of survival or time to recurrence was calculated from the date of operation to the date of event or the last follow-up date.…”

Thymic Epithelial Tumors: Prognostic Determinants Among Clinical, Histopathologic, and Computed Tomography Findings

“…Not surprisingly, the authors found that clinical staging based on CT features could be used to discriminate between stages and was prognostic for survival and progressionfree survival. The CT images included in their study are particularly helpful in illustrating the relevant CT features of the different stages, and their paper adds to the small but growing literature on radiographic assessment of TETs: Marom and colleagues [2] have demonstrated that radiographic features can accurately predict advanced Masaoka stage, and Hayes and colleagues [3] have demonstrated that resectability can likewise be predicted using radiographic features. While it is reassuring that staging of TETs using CT features is prognostic, the value of clinical staging ultimately depends on how closely it correlates with the actual pathologic stage.…”

“…hence, such a simple prognostic definition or policy (freedom from recurrence or time to progression) suggested by ITMIG could not be adopted [3]. Therefore, in our study, we used the term progression-free survival (PFS) for all patients as the combined definition for freedom from recurrence and time to progression.…”

“…For TET, CT staging is effective in distinguishing both overall survival and progression-free survival, and patients with Masaoka-Koga stage IV or thymic carcinoma or CT stage IV have the worst prognosis. Group (ITMIG), together with the International Association for the Study of Lung Cancer and under the auspices of the Union International Contre le Cancer and American Joint Commission on Cancer, provided infrastructures for international collaboration in terms of common language, consistent definition, and international database especially for outcome measurement, surgical procedure, and staging system [1][2][3]. Regarding the prognosis of thymic epithelial tumor (TET), the ITMIG and associated groups reviewed current literature to identify prognostic determinants.…”

Long-Term Outcomes of Recurrent Thymoma

“…The Masaoka-Koga staging systems [13] were adopted and pathologic results were classified according to WHO histological classification [14]. Recurrent thymoma and recurrence patterns were identified based on the International Thymic Malignancy Interest Group (ITMIG) definitions [15]. One oncologist and two radiologists diagnosed patients with recurrence according to clinical symptoms and the results of CT scan and MRI when needed.…”