The International Association for the Study of Lung Cancer Thymic Epithelial Tumor Staging Project: Unresolved Issues to be Addressed for the Next Ninth Edition of the TNM Classification of Malignant Tumors

Ruffini, E.; Rami-Porta, R.; Huang, J.; Ahmad, U.; Appel, S.; Bille, A.; Boubia, S.; Brambilla, C.; Cangir, A. K.; Cilento, V.; Detterbeck, F.; Falkson, C.; Fang, W.; Filosso, P. L.; Giaccone, G.; Girard, N.; Guerrera, F.; Infante, M.; Kim, D. K.; Lucchi, M.; Marino, M.; Marom, E. M.; Nicholson, A. G.; Okumura, M.; Rimner, A.; Simone, C. B.; Asamura, H.; Rusch, V.; Araujo, L. H.; Beer, D.; Bertoglio, P.; Beyruti, R.; Brambilla, E.; Cangir, A. K.; Connolly, C.; Darling, G.; Dibaba, D.; D' Journo, X. B.; Eberhardt, W.; Erasmus, J.; Fennell, D.; Fong, K.; Galateau-Salle, F.; Gill, R. R.; Giroux, D.; Giuliani, M.; Goo, J. M.; Hirsch, F.; Hoffman, H.; Hofstetter, W.; Joubert, P.; Kernstine, K.; Kerr, K.; Kim, Y. T.; Lievens, Y.; Liu, H.; Low, D. E.; Lyons, G.; Macmahon, H.; Matilla, J. -M.; Meerbeeck, J. V.; Montuenga, L. M.; Nicholson, A.; Nishimura, K.; Nowak, A.; Opitz, I.; Osarogiagbon, R. U.; Pass, H.; de Perrot, M.; Rice, D.; Rosenthal, A.; Sakai, S.; Van Schil, P.; Singh, N.; Suarez, F.; Terra, R. M.; Travis, W. D.; Tsao, M. S.; Ugalde, P.; Watanabe, S. -I.; Wistuba, I.; Wynes, M.; Yatabe, Y.; Armato, S.; Berzenji, L.; Brunelli, A.; Cardillo, G.; Chen, K.; Cooper, W.; Jiang, L.; Krasnik, M.; Kubota, K.; Labbe, C.; Lee, H. Y.; Lim, E.; Liu, G.; Liu, H.; Mack, P.; Naidich, D.; Nishino, M.; Ostrowski, M.; Powell, C.; Presley, C.; Putora, P. M.; Ren, H.; Rivera, M. P.; Rocco, G.; Ruiz Tzukazan, M. T.; Samstein, R.; Soon, Y. Y.; Suda, K.; Tammemagi, M.; Turna, A.; Weksler, B.; Williams, T.; Yang, D.; Yang, J.; Yotsukura, M.; Falkson, C. B.; Ferguson, M.; Sauter, J.; Wolf, A.; Filosso, P. L.; Kim, H. K.; Kim, H. K.

doi:10.1016/j.jtho.2022.03.005

Thymic epithelial tumors are presently staged using a consistent TNM classification developed by the International Association for the Study of Lung Cancer (IASLC) and approved by the Union for International Cancer Control and the American Joint Committee on Cancer. The stage classification is incorporated in the eight edition of the TNM classification of thoracic malignancies. The IASLC Staging and Prognostic Factors Committee (SPFC)—Thymic Domain (TD) is in charge for the next (ninth) edition expected in 2024. The present article represents the midterm report of the SPFC-TD: in particular, it describes the unresolved issues identified by the group in the current stage classification which are worth being addressed and discussed for the ninth edition of the TNM classification on the basis of the available data collected in the central thymic database which will be managed and analyzed by Cancer Research And Biostatistics. These issues are grouped into issues of general importance and those specifically related to T, N, and M categories. Each issue is described in reference to the most recent reports on the subject, and the priority assigned by the IASLC SPFC-TD for the discussion of the ninth edition is provided.