The IASLC/ITMIG Thymic Epithelial Tumors Staging Project: Proposal for an Evidence- Based Stage Classification System for the Forthcoming (8th) Edition.

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The IASLC/ITMIG Thymic Epithelial Tumors Staging Project: Proposal for an Evidence- Based Stage Classification System for the Forthcoming (8th) Edition of the TNM Classification of Malignant Tumors Frank C. Detterbeck, MD, Kelly Stratton, MS, Dorothy Giroux, MS, Hisao Asamura, MD, John Crowley, PhD, Conrad Falkson, MBChB, Pier Luigi Filosso, MD, Aletta A. Frazier, MD, Giuseppe Giaccone, MD, James Huang, MD, Jhingook Kim, MD, Kazuya Kondo, MD, Marco Lucchi, MD, Mirella Marino, MD, Edith M. Marom, MD, Andrew G. Nicholson, MD, Meinoshin Okumura, MD, Enrico Ruffini, MD, Paul Van Schil, MD Journal of Thoracic Oncology Volume 9, Issue 9, Pages S65-S72 (September 2014) DOI: 10.1097/JTO.0000000000000290 Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 ITMIG/IASLC node compartments for thymic malignancies. Graphic depiction of N1 (anterior region, blue) and N2 (deep region, purple) node compartments. A, Level of thoracic inlet; (B) Level of aortopulmonary window; (C) Sagittal view. For further details, see Bhora et al.12 Journal of Thoracic Oncology 2014 9, S65-S72DOI: (10.1097/JTO.0000000000000290) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Stages I (T1N0M0) and II (T2N0M0). Graphic depiction of Stage group I and II. Copyright © Aletta Ann Frazier, MD. A, Stage I: tumor that is either “encapsulated” or extending into the anterior mediastinal fat (T1a) or with direct involvement of the mediastinal pleura (T1b); (B) Stage II. Tumor invading the pericardium (either partial or full thickness). Journal of Thoracic Oncology 2014 9, S65-S72DOI: (10.1097/JTO.0000000000000290) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Stage IIIa (T3N0M0) and IIIb (T4N0M0). Graphic depiction of Stage group IIIa, b. Copyright © Aletta Ann Frazier, MD. A, Tumor invading the lung, brachiocephalic vein, superior vena cava, chest wall, and phrenic nerve; (B) Tumor invading the aorta, intrapericardial pulmonary artery, myocardium, trachea, and esophagus. Journal of Thoracic Oncology 2014 9, S65-S72DOI: (10.1097/JTO.0000000000000290) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 Stages IVa and IVb. Graphic depiction of Stage group IVa, b. Copyright © Aletta Ann Frazier, MD. A, Tumor with separate pleural or pericardial nodules (M1a) or anterior region node involvement (N1); (B) Tumor with deep region node involvement (N2) or distant metastases including intraparenchymal pulmonary nodules (M1b). Journal of Thoracic Oncology 2014 9, S65-S72DOI: (10.1097/JTO.0000000000000290) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions