Objectives
  • To be able to perform specialist assessment, treatment and counselling of patients with thymoma and thymic cancer

Awareness
  • Recognition of the rarity of thymoma and thymic cancer

  • Appreciation of differences between thymoma and thymic cancer regarding pathology, biology and outcome, for the selection of appropriate treatment strategies

  • Awareness of the association of thymoma with multiple endocrine neoplasia (MEN) type 1

  • Awareness of the association of thymoma with autoimmune disorders

  • Awareness of the availability of different diagnostic procedures for thymoma and thymic cancer

  • Awareness of the existence of different prognostic factors

  • Appreciation of the criteria and their limitations to define resectable and non-resectable disease

  • Recognition of the importance of the multimodality approach to treat patients with thymoma and thymic cancer

Knowledge
  • Familiarity with the implications of the clinical, pathological and biological differences between thymoma and thymic cancer for the selection of appropriate treatment strategies

  • Familiarity with the indications for, expectations from and limitations of the different diagnostic tools available for the identification of thymoma and thymic cancer (including computed tomography (CT), positron emission tomography (PET), magnetic resonance imaging (MRI)) and with differential diagnoses

  • Understanding of the clinical situations where pretreatment biopsy is required or not

  • Familiarity with the clinical and biological assessment of the most frequent thymoma-associated autoimmune disorders, especially myasthenia gravis

  • Familiarity with the risk assessment work-up of prognostic factors, especially the staging systems (Masaoka–Koga and TNM), and the criteria that define resectability and non-resectability, including their limitations

  • Familiarity with the principles and indications of surgery and postoperative radiotherapy for the treatment of resectable thymoma and thymic cancer

  • Familiarity with the principles and indications of primary and exclusive chemotherapy and definitive radiotherapy for the treatment of advanced disease

  • Understanding of the role of surgery, radiotherapy and chemotherapy in the management of patients with recurrent disease

  • Familiarity with the principles of the follow-up of patients, including the long-term implications regarding autoimmune disorders

Skills
  • Ability to contribute actively to a variety of thymoma and thymic cancer clinical scenarios and patient presentations

  • Ability to discuss critically the treatment options/recommendations

  • Ability to perform a history and physical examination in patients with thymoma and thymic cancer

  • Ability to contribute to multidisciplinary discussions on general management strategies in order to understand all the considerations on which treatment to use and which sequence to select for the multidisciplinary strategy

  • Ability to prescribe various chemotherapeutic agents considering their potential interactions with radiation therapy

  • Ability to manage side effects of various chemotherapeutic agents

  • Ability to recognise considerations in multimodal treatment sequences, including surgery, chemotherapy (primary, exclusive) and radiotherapy (postoperative, definitive), at the time of initial management and when recurrences occur

  • Ability to discuss follow-up strategies with patients