On the staging of thymic epithelial neoplasms
The recent article by White et al. in the European Journal of Cardiothoracic Surgery on the efficacy of chest computed tomography prediction of the pathological TNM stage of thymic epithelial tumors (1) underscores an issue that has impacted the field of thymoma studies, namely what is the proper way for staging such tumors. The study by White et al. (1) shows that preoperative chest CT is able to accurately predict p-TNM stage in only two thirds of surgically resected thymic epithelial tumors. Thus, one third of patients will have false positives or false negatives that may adversely affect the management options for those patients, including decisions of whether to offer preoperative radiation that may lead to incomplete surgical resections or overtreatment of the lesions with added morbidity.