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Non-metastatic NSCLC and other thoracic malignancies

3514 - Pathological central review of 400 thymic epithelial tumors (TET): The national network RYTHMIC experience


10 Oct 2016


Non-metastatic NSCLC and other thoracic malignancies


Thierry Molina


Annals of Oncology (2016) 27 (6): 522-525. 10.1093/annonc/mdw391


T. Molina1, M.V. Bluthgen2, L. Chalabreysse3, V. De Montpréville4, A. De Muret5, V. Hofman6, S. Lantuejoul7, M. Parrens8, I. Rouquette9, V. Secq10, N. Girard11, A. Marx12, B. Besse2

Author affiliations

  • 1 Department Of Pathology, GH Necker - Enfants Malades, 75015 - Paris/FR
  • 2 Cancer Medicine, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 3 Service D'anatomie Pathologique, hôpital Louis-Pradel, Lyon/FR
  • 4 Service D'anatomie Pathologique, centre chirurgical Marie-Lannelongue, Le Plessis-Robinson/FR
  • 5 Service D'anatomie Pathologique, CHU de Tours, Tours/FR
  • 6 Service D'anatomie Pathologique, hôpital Pasteur, Nice/FR
  • 7 Service D'anatomie Pathologique, CHU de Grenoble, Grenoble/FR
  • 8 Service D'anatomie Pathologique, CHU de Bordeaux, Bordeaux/FR
  • 9 Service D'anatomie Pathologique, Institut Universitaire du Cancer -Toulouse- Oncopole, Toulouse/FR
  • 10 Service D'anatomie Pathologique, Hopital Nord, Marseille/FR
  • 11 Department Of Respiratory Medicine, Louis Pradel Hospital, Lyon/FR
  • 12 Pathology, Universitätsklinikum Mannheim, 68167 - Mannheim/DE


Abstract 3514


RYTHMIC (Réseau tumeurs THYMiques et Cancer) is a nationwide network for TET appointed in 2012 by the French National Cancer Institute. The objectives of the network are management of clinical tumor board and central pathologic review of all cases. RYTHMIC Tumor Board is based on initial histopathological diagnosis.


Pathological central review of patients diagnosed with TET from January 2012 to May 2016 was made by a panel of 10 expert pathologists from the working group. Assessment of agreement or disagreement between the initial institution and the panel review was made according the WHO 2004/2015 and new ITMIG proposals for histologic typing and staging. Discordances were classified as “major” when they would have changed the therapy or management of patients according to the RYTHMIC guidelines.


A total of 400 specimens were reviewed. Considering either histological subtype and/or staging, a total of 172 discordances in 157 patients (39%) were identified as follow: 111 concerning histological diagnosis and 61 regarding stage. A total of 31 major discordances in 29 patients (7%) were identified: 18 patients for whom post-surgical treatment recommendation concerning adjuvant radiotherapy would have been changed and 11 patients for whom management of disease should have been modified. The most frequent disagreement was the sub-diagnosis of stage III reflecting the underlying difficulty in pericardial and/or mediastinal pleura histological invasion. Additionally, major disagreement between the initial and panel pathology's stage and subsequent interpretation by the working group at national tumor board was found in 4 patients, enhancing the importance of an expert pathologist at the RYTHMIC network committee.


The RYTHMIC experience confirms the relevance of an expert histopathological panel diagnosis of thymic malignancies and for better decision-making in particular concerning post-operative radiotherapy to avoid over- or under-treatment of the patients.

Clinical trial identification

Legal entity responsible for the study





All authors have declared no conflicts of interest.

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