第8版恶性肿瘤分期的基于肿瘤、淋巴结和转移（TNM）的阶段分类系统被应用于胸腺上皮肿瘤的分期。国际肺癌研究协会的分期与预后因素委员会胸腺领域开发了一个新的数据库，旨在为第9版分期分类系统提出建议。本文概述了第9版TNM分期胸腺恶性肿瘤的T分类的建议定义。我们汇编了一个全球统一数据库，包括11,347名有胸腺上皮肿瘤的患者。针对9,147名有可用存活数据的患者进行了分析。作为结果指标，我们使用总体生存率、无复发生存率和复发累积发生率。分别对胸腺瘤、胸腺癌和神经内分泌胸腺肿瘤进行了独立分析。 T分类的建议包括：T1分类分为T1a（≤5cm）和T1b（>5cm），与纵隔胸膜浸润无关；T2包括对心包、肺或肋膜的直接侵犯；T3表示对颈臂静脉、上腔静脉、胸壁或外心包肺动脉和静脉的直接侵犯；而T4分类与第8版分类相同，包括对主动脉和弓形血管、心包内肺动脉和静脉、心肌、气管或食管的直接侵犯。 第9版TNM分类的T分类提供了对于胸腺上皮肿瘤基于TNM的分期系统中T组分有良好的预后区分能力。版权所有 © 2023 Elsevier Inc.发表。

A tumor, node, metastases (TNM)-based stage classification system of thymic epithelial tumors was adopted for the 8th edition of the stage classification of malignant tumors. The Thymic Domain of the Staging and Prognostics Factor Committee of the International Association for the Study of Lung Cancer developed a new database with the purpose to make proposals for the 9th edition stage classification system. This article outlines the proposed definitions for the T categories for the 9th Ed. TNM stage classification of thymic malignancies.A worldwide collective database of 11,347 patients with thymic epithelial tumors was assembled. Analysis was performed on 9,147 patients with available survival data. Overall survival, freedom-from-recurrence and cumulative incidence of recurrence were used as outcome measures. Analysis was performed separately for thymomas, thymic carcinomas and neuroendocrine thymic tumors.Proposals for the T categories include: T1 category is divided into T1a (≤5cm) and T1b (>5cm) irrespective of mediastinal pleura invasion; T2 includes direct invasion of pericardium, lung or phrenic nerve; T3 denotes direct invasion of the brachiocephalic vein, superior vena cava, chest wall, or extrapericardial pulmonary arteries and veins; and T4 category remains the same as in the 8th Ed. classification, involving direct invasion of the aorta and arch vessels, intrapericardial pulmonary arteries and veins, myocardium, trachea, or esophagus.The proposed T categories for the 9th edition of the TNM classification provide good discrimination in outcome for the T component of the TNM-based stage system of thymic epithelial tumors.Copyright © 2023. Published by Elsevier Inc.