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Staging (Thymoma and Thymic Carcinoma)
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Staging (Thymoma and Thymic Carcinoma)
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Pathologic Stage Classification (pTNM, AJCC 8th Edition) (Note D) CAP Approved Thymic Tumors – 4.0.0.0
TNM Descriptors (required only if applicable) (select all that apply)
___ m (multiple primary tumors)
___ r (recurrent)
___ y (posttreatment)
Primary Tumor (pT)
___ pTX: Primary tumor cannot be assessed
___ pT0: No evidence of primary tumor
___ pT1: Tumor encapsulated or extending into the mediastinal fat; may involve the mediastinal pleura
___ pT1a: Tumor with no mediastinal pleura involvement
___ pT1b: Tumor with direct invasion of mediastinal pleura
___ pT2: Tumor with direct invasion of the pericardium (either partial or full thickness)
___ pT3: Tumor with direct invasion into any of the following: lung, brachiocephalic vein, superior vena cava, phrenic nerve, chest wall, or extrapericardial pulmonary artery or veins
___ pT4: Tumor with invasion into any of the following: aorta (ascending, arch, or descending), arch vessels, intrapericardial pulmonary artery, myocardium, trachea, esophagus
Regional Lymph Nodes (pN)
___ pNX: Regional lymph nodes cannot be assessed
___ pN0: No regional lymph node metastasis
___ pN1: Metastasis in anterior (perithymic) lymph nodes
___ pN2: Metastasis in deep intrathoracic or cervical lymph nodes Distant Metastasis (pM) (required only if confirmed pathologically in this case)
___ pM1: Pleural, pericardial, or distant metastasis
___ pM1a: Separate pleural or pericardial nodule(s)
___ pM1b: Pulmonary intraparenchymal nodule or distant organ metastasis Specify site(s), if known: ____________________________
Summary of changes – AJCC 7th to 8th Edition
- New pTNM staging – required
- Still report the Masaoka Stage (historically used) Transcapsular invasion added