{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T06:41:04Z","timestamp":1791009664476,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2008,4,28]],"date-time":"2008-04-28T00:00:00Z","timestamp":1209340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2008,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND.<\/jats:title><jats:p>The clinical validity and applicability of the World Health Organization (WHO) histopathologic classification of thymomas (\u2018classification\u2019) has been questioned. Evidence\u2010based pathology promotes the use of systematic reviews and analysis of data with meta\u2010analysis rather than subjective reviews of the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS.<\/jats:title><jats:p>The authors performed a review of the English literature from 1999 to the present to identify \u2018best evidence\u2019 regarding the use of the \u2018classification.\u2019 The data were analyzed with meta\u2010analysis software.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS.<\/jats:title><jats:p>To the authors' knowledge, only Level\u20103 or \u20104 evidence published in retrospective cases series is currently available regarding the use of the \u2018classification.\u2019 Meta\u2010analysis demonstrated that only 3 WHO categories of thymomas are associated with significant survival differences: A\/AB\/B1, B2, and B3. It also indicated significant heterogeneity with regard to the results published in different studies. To the authors' knowledge there is no current evidence to determine whether thymoma types are significant prognostic features for patients previously stratified by stage.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS.<\/jats:title><jats:p>There is a lack of randomized clinical trials evaluating the prognosis of patients with thymomas and the effects of various treatment modalities. The WHO classification of thymomas needs revision and could most likely be simplified into fewer classes with significant prognostic value. Future studies are needed to evaluate the prognostic and\/or predictive value for thymoma patients previously stratified by stage. The latter information is important to help select those patients who may benefit from neoadjuvant chemotherapy or postoperative radiotherapy and other modalities. Cancer 2008. \u00a9 2008 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.23492","type":"journal-article","created":{"date-parts":[[2008,4,28]],"date-time":"2008-04-28T17:46:34Z","timestamp":1209404794000},"page":"2780-2788","source":"Crossref","is-referenced-by-count":81,"title":["Evidence\u2010based pathology and the pathologic evaluation of thymomas"],"prefix":"10.1002","volume":"112","author":[{"given":"Alberto M.","family":"Marchevsky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruta","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"McKenna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Wick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar","family":"Moran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen F.","family":"Zakowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul","family":"Suster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,4,28]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2005.031138"},{"key":"e_1_2_6_3_2","first-page":"339","article-title":"The mediastinum","volume":"3","author":"Marchevsky A","year":"1996","journal-title":"Pathology (Phila)."},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)40093-9"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(20)31934-6"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19811201)48:11<2485::AID-CNCR2820481123>3.0.CO;2-R"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(78)80131-2"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.11.067"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00737071"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199212000-00003"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1309\/CAV8RNU5TKNACKNC"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/112.3.308"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/111.6.826"},{"key":"e_1_2_6_14_2","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/S1052-3359(25)00577-0","article-title":"Histologic typing of thymoma according to the new World Health Organization classification","volume":"11","author":"Dadmanesh F","year":"2001","journal-title":"Chest Surg Clin N Am."},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-005-3047-y"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2006.02.004"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10665"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2003.07.042"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1569-9293(03)00265-2"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2006.01.002"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2004.06.004"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7304.101"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7261.585"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7165.1088b"},{"key":"e_1_2_6_25_2","first-page":"471","article-title":"Bias in meta\u2010analysis detected by a simple, graphical test. 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