title: Thymic Carcinoma Management Patterns among International Thymic Malignancy Interest Group (ITMIG) Physicians with Consensus from the Thymic Carcinoma Working Group.
abstract: Thymic carcinomas are rare epithelial malignancies with limited data to guide management.
  
  
  
  To identify areas of agreement and variability in current clinical practice, a 16-question electronic survey was given to members of the International Thymic Malignancy Interest Group (ITMIG). Areas of controversy were discussed with the Thymic Carcinoma Working Group and consensus was achieved, as described.
  
  
  
  A total of 100 ITMIG members responded. There was general agreement regarding the role for multimodality therapy with definitive surgical resection in physically fit patients with advanced but resectable disease. Areas of controversy included the need for histologic confirmation before surgery, the role of adjuvant therapy, the optimal first-line chemotherapy regimen, and the recommended treatment course for marginally resectable disease with invasion into the great vessels, pericardium, and lungs.
  
  
  
  The results of the questionnaire provide a description of the management of thymic carcinoma by 100 ITMIG members with a specific interest or expertise in thymic malignancies. Although there was agreement in some areas, clinical practice appears to vary significantly. There is a great need for collaborative research to identify optimal evaluation and treatment strategies. Given the need for multimodality therapy in many cases, a multidisciplinary discussion of the management of patients with thymic carcinoma is critical.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Shepherd
authors.affiliation: Department of Thoracic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Gregory
authors.initials: G
authors.lastname: Riely
authors.affiliation: Department of Thoracic Surgery, Yale University, New Haven, Connecticut.
authors.forename: Frank
authors.initials: F
authors.lastname: Detterbeck
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Simone
authors.affiliation: Department Thoracic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Usman
authors.initials: U
authors.lastname: Ahmad
authors.affiliation: Department of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: James
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department Thoracic Surgery, Valley Hospital, New Jersey.
authors.forename: Robert
authors.initials: R
authors.lastname: Korst
authors.affiliation: Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Arun
authors.initials: A
authors.lastname: Rajan
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: rimnera@mskcc.org.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rimner
mesh_terms: D019468:Disease Management; D006801:Humans; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D013945:Thymoma / Q000175:diagnosis / Q000628:therapy*; D013953:Thymus Neoplasms / Q000175:diagnosis / Q000628:therapy*
keywords: Clinical management; Multimodality therapy; Survey; Thymic carcinoma