For thymic carcinoid confirmed as radically resectable and staged at UICC TNM stage I, II, or III, upfront surgical resection is the primary approach. The clinical question that arises after surgery is whether — and in what form — additional postoperative treatment is warranted.
Thymic carcinoid assessed as radically resectable, at UICC TNM stage I, II, or III. Upfront surgery can be offered for all thymic carcinoids in this setting. The extent of resection and final pathological staging are the key factors that guide subsequent decisions.
After resection, the need for further treatment is evaluated individually for each patient. Depending on resection margins and stage, case-by-case discussion may lead to additional local or systemic postoperative approaches. The complete set of options, their indications, and the sequencing algorithm are detailed in the full protocol.
Upfront surgery can be offered for all ThCs deemed radically resectable [IV, B].
Thymic carcinoid — UICC TNM stage I–III
Case-by-case discussion is recommended for additional local and or systemic options in ThCs with R0 (if stage 3 or 4) or R1 or R2 resection [V, C].
The majority of the author panel suggests individually discussing postoperative therapies, including RT and/or systemic therapies (with options discussed in these guidelines), with patients with advanced-stage R0 or R1-2 resection [V, C].
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