Advances in Surgical Sciences

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Comparison of Radiology and Histopathology in Thymic Epithelial Tumours

Received: 24 February 2017    Accepted: 28 March 2017    Published: 17 April 2017
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Abstract

Tumours of the thymus gland have a limited evidence base due to their low incidence rate. The Masaoka-Koga staging system has been known as the strongest prognostic indicator for both survival and recurrence of thymic tumours but there is no standardised way to assess clinical staging in pre-operative images. As appropriate staging can influence patients’ need for adjuvant therapy, it is important to evaluate if current imaging can accurately predict post-operative staging. This was a retrospective study comparing the pre-operative radiological staging and post-operative pathological staging of 34 patients. This was conducted at the Golden Jubilee National Hospital between March 2013 and October 2016. A Kappa statistic was used to evaluate agreement between the assessments. 61.8% (21 out of 34) of the CT stages agreed with the pathology stages: 78.6% (11 out of 14) in stage I; 41.7% (5 out of 12) in stage II; 40% (2 out of 5) in stage III; and 100% (3 out of 3) in stage IV. There was moderate agreement between the preoperative CT assessment and the post-operative pathological staging (kappa coefficient = 0.42, p value < 0.01). With further analysis of a larger sample size it could be concluded that radiological staging of thymic tumours before surgery is quite accurate but requires standardisation and utilisation of other imaging techniques to ensure appropriate levels of care.

DOI 10.11648/j.ass.20170501.12
Published in Advances in Surgical Sciences (Volume 5, Issue 1, February 2017)
Page(s) 7-14
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Thymoma, Masaoka-Koga Staging, Histopathology

References
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[4] BARNES, E. W. & IRVINE, W. J. 1973. Clinical syndromes associated with thymic disorders. Proc R Soc Med, 66, 151-4.
[5] KOGA, K., MATSUNO, Y., NOGUCHI, M., MUKAI, K., ASAMURA, H., GOYA, T. & SHIMOSATO, Y. 1994. A review of 79 thymomas: modification of staging system and reappraisal of conventional division into invasive and non-invasive thymoma. Pathol Int, 44, 359-67.
[6] MASAOKA, A., MONDEN, Y., NAKAHARA, K. & TANIOKA, T. 1981. Follow-up study of thymomas with special reference to their clinical stages. Cancer, 48, 2485-92.
[7] REGNARD, J. F., MAGDELEINAT, P., DROMER, C., DULMET, E., DE MONTPREVILLE, V., LEVI, J. F. & LEVASSEUR, P. 1996. Prognostic factors and long-term results after thymoma resection: a series of 307 patients. J Thorac Cardiovasc Surg, 112, 376-84.
[8] ATTARAN, S., MCCORMACK, D., PILLING, J. & HARRISON-PHIPPS, K. 2012. Which stages of thymoma benefit from adjuvant chemotherapy post-thymectomy? Interact Cardiovasc Thorac Surg, 15, 273-5.
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[11] DETTERBECK, F. C., NICHOLSON, A. G., KONDO, K., VAN SCHIL, P. & MORAN, C. 2011. The Masaoka-Koga stage classification for thymic malignancies: clarification and definition of terms. J Thorac Oncol, 6, S1710-6.
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[14] FALKSON, C. B., BEZJAK, A., DARLING, G., GREGG, R., MALTHANER, R., MAZIAK, D. E., YU, E., SMITH, C. A., MCNAIR, S., UNG, Y. C., EVANS, W. K. & LUNG CANCER DISEASE SITE GROUP OF CANCER CARE ONTARIO'S PROGRAM IN EVIDENCE-BASED, C. 2009. The management of thymoma: a systematic review and practice guideline. J Thorac Oncol, 4, 911-9.
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[19] QU, Y. J., LIU, G. B., SHI, H. S., LIAO, M. Y., YANG, G. F. & TIAN, Z. X. 2013. Preoperative CT findings of thymoma are correlated with postoperative Masaoka clinical stage. Acad Radiol, 20, 66-72.
[20] MOON, JUNG WON et al. "Thymic Epithelial Tumors: Prognostic Determinants Among Clinical, Histopathologic, And Computed Tomography Findings". The Annals of Thoracic Surgery 99.2 (2015): 462-470. Web.
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Author Information
  • College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland

  • Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, Scotland

  • Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, Scotland

  • Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, Scotland

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  • APA Style

    Blane Gordon McMillan, Sanjeet Avtaar Singh, Sudeep Das De, Alan Kirk. (2017). Comparison of Radiology and Histopathology in Thymic Epithelial Tumours. Advances in Surgical Sciences, 5(1), 7-14. https://doi.org/10.11648/j.ass.20170501.12

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    ACS Style

    Blane Gordon McMillan; Sanjeet Avtaar Singh; Sudeep Das De; Alan Kirk. Comparison of Radiology and Histopathology in Thymic Epithelial Tumours. Adv. Surg. Sci. 2017, 5(1), 7-14. doi: 10.11648/j.ass.20170501.12

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    AMA Style

    Blane Gordon McMillan, Sanjeet Avtaar Singh, Sudeep Das De, Alan Kirk. Comparison of Radiology and Histopathology in Thymic Epithelial Tumours. Adv Surg Sci. 2017;5(1):7-14. doi: 10.11648/j.ass.20170501.12

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  • @article{10.11648/j.ass.20170501.12,
      author = {Blane Gordon McMillan and Sanjeet Avtaar Singh and Sudeep Das De and Alan Kirk},
      title = {Comparison of Radiology and Histopathology in Thymic Epithelial Tumours},
      journal = {Advances in Surgical Sciences},
      volume = {5},
      number = {1},
      pages = {7-14},
      doi = {10.11648/j.ass.20170501.12},
      url = {https://doi.org/10.11648/j.ass.20170501.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ass.20170501.12},
      abstract = {Tumours of the thymus gland have a limited evidence base due to their low incidence rate. The Masaoka-Koga staging system has been known as the strongest prognostic indicator for both survival and recurrence of thymic tumours but there is no standardised way to assess clinical staging in pre-operative images. As appropriate staging can influence patients’ need for adjuvant therapy, it is important to evaluate if current imaging can accurately predict post-operative staging. This was a retrospective study comparing the pre-operative radiological staging and post-operative pathological staging of 34 patients. This was conducted at the Golden Jubilee National Hospital between March 2013 and October 2016. A Kappa statistic was used to evaluate agreement between the assessments. 61.8% (21 out of 34) of the CT stages agreed with the pathology stages: 78.6% (11 out of 14) in stage I; 41.7% (5 out of 12) in stage II; 40% (2 out of 5) in stage III; and 100% (3 out of 3) in stage IV. There was moderate agreement between the preoperative CT assessment and the post-operative pathological staging (kappa coefficient = 0.42, p value < 0.01). With further analysis of a larger sample size it could be concluded that radiological staging of thymic tumours before surgery is quite accurate but requires standardisation and utilisation of other imaging techniques to ensure appropriate levels of care.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - Comparison of Radiology and Histopathology in Thymic Epithelial Tumours
    AU  - Blane Gordon McMillan
    AU  - Sanjeet Avtaar Singh
    AU  - Sudeep Das De
    AU  - Alan Kirk
    Y1  - 2017/04/17
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    N1  - https://doi.org/10.11648/j.ass.20170501.12
    DO  - 10.11648/j.ass.20170501.12
    T2  - Advances in Surgical Sciences
    JF  - Advances in Surgical Sciences
    JO  - Advances in Surgical Sciences
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    EP  - 14
    PB  - Science Publishing Group
    SN  - 2376-6182
    UR  - https://doi.org/10.11648/j.ass.20170501.12
    AB  - Tumours of the thymus gland have a limited evidence base due to their low incidence rate. The Masaoka-Koga staging system has been known as the strongest prognostic indicator for both survival and recurrence of thymic tumours but there is no standardised way to assess clinical staging in pre-operative images. As appropriate staging can influence patients’ need for adjuvant therapy, it is important to evaluate if current imaging can accurately predict post-operative staging. This was a retrospective study comparing the pre-operative radiological staging and post-operative pathological staging of 34 patients. This was conducted at the Golden Jubilee National Hospital between March 2013 and October 2016. A Kappa statistic was used to evaluate agreement between the assessments. 61.8% (21 out of 34) of the CT stages agreed with the pathology stages: 78.6% (11 out of 14) in stage I; 41.7% (5 out of 12) in stage II; 40% (2 out of 5) in stage III; and 100% (3 out of 3) in stage IV. There was moderate agreement between the preoperative CT assessment and the post-operative pathological staging (kappa coefficient = 0.42, p value < 0.01). With further analysis of a larger sample size it could be concluded that radiological staging of thymic tumours before surgery is quite accurate but requires standardisation and utilisation of other imaging techniques to ensure appropriate levels of care.
    VL  - 5
    IS  - 1
    ER  - 

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