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Poster Display session

218P - Implications of the eighth edition of TNM staging system for thymoma, a single-center retrospective study


31 Mar 2023


Poster Display session


Iddo Vardi


Journal of Hepatology (2023) 18 (4S): S154-S159.


I. Vardi1, D. Halperin2, O. Ben David Ohayone3, A. Stemmer3, S. Sagie3, D. Urban3, S. Appel3, H. Gantz Sorotsky3, E. Marom3, J. Bar4

Author affiliations

  • 1 Ramat Gan/IL
  • 2 Tel aviv university, tel aviv/IL
  • 3 Chaim Sheba Medical Center, Ramat Gan/IL
  • 4 Chaim Sheba Medical Center, 52621 - Ramat Gan/IL


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Abstract 218P


Thymic epithelial tumors are rare malignancies that arise in the prevascular mediastinum. The Masaoka-Koga (MK) staging system is traditionally used for staging. In 2017 the 8th edition of TNM classification was published and is gaining acceptance.


A retrospective study of all patients who underwent surgery for thymoma between 2011 and 2022 at our institute. Kaplan-Meier survival analysis was used to calculate overall survival.


Among 125 patients identified, 62 were men (50%). Median age was 52.8 years. 45 patients (36%) were diagnosed with myasthenia gravis during the course of the disease. Frequency of B2 thymoma was much higher in our cohort compared to previous studies (N = 65, 52%). According to MK staging system there were 50 stage I (40%), 47 stage IIa/b (∼37%), 21 stage III (∼16%) and seven stage IVa/b (5.5%). After re-staging according to the 8th edition TNM staging classification, all MK stage II patients were down staged to stage I. Eight patients were down staged from stage III – six to stage II and two to stage I. Both MK and TNM staging systems were associated with overall survival. 5-year survival was 94% and 10-year survival was 89%. Tumor size, histology and myasthenia gravis were not correlated with survival. Recurrences were seen as late as 8 years following surgery.


This is the first Israeli surgical series of patients with thymoma in recent years. Re-staging according to the 8th edition TNM staging caused significant down staging of tumors.

Legal entity responsible for the study

The authors.


Has not received any funding.


D. Urban: Financial Interests, Personal, Invited Speaker: Merck, Sharpe & Dohme, Takeda, Roche Israel, Rhenium/Oncotest, Bristol Myers Squibb, AstraZeneca. H. Gantz Sorotsky: Financial Interests, Personal, Invited Speaker: Roche-Genentech, MSD, AstraZeneca, Takeda, Astellas, BMS, Pfizer, Medison, Novartis, Boehringer Ingelheim International. E. Marom: Financial Interests, Personal, Invited Speaker: AstraZeneca, Boehringer Ingelheim, Merck Sharp & Dohme. J. Bar: Financial Interests, Personal, Advisory Board: AbbVie, AstraZeneca, Bayer, BMS, Causalis, MSD, Novartis, Roche, Takeda; Financial Interests, Personal, Research Grant: Immunai, OncoHost, MSD, AstraZeneca. All other authors have declared no conflicts of interest. The author has declared no conflicts of interest.

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