The IASLC Lung Cancer Staging Project: Proposals for the Revision of the TNM Stage Groupings in the Forthcoming (Seventh) Edition of the TNM Classification of Malignant Tumours

By P. Goldstraw, J. Crowley, K. Chansky, D. Giroux, P. Groome, R. Rami-Porta, P. Postmus, V. Rusch, Leslie Sobin. Journal of Thoracic Oncology, 2007

3,596 citations recorded by the source corpus.

Introduction: The seventh edition of the TNM Classification of Malignant Tumors is due to be published early in 2009. In preparation for this, the International Association for the Study of Lung Cancer established its Lung Cancer Staging Project in 1998. The recommendations of this committee for changes to the T, N, and M descriptors have been published. This report contains the proposals for the new stage groupings. Methods: Data were contributed from 46 sources in more than 19 countries. Adequate data were available on 67,725 cases of non-small cell lung cancer treated by all modalities of care between 1990 and 2000. The recommendations for changes to the T, N, and M descriptors were incorporated into TNM subsets. Candidate stage groupings were developed on a training subset and tested in a validation subset. Results: The suggestions include additional cutoffs for tumor size, with tumors >7 cm moving from T2 to T3; reassigning the category given to additional pulmonary nodules in some locations; and reclassifying pleural effusion as an M descriptor. In addition, it is suggested that T2b N0 M0 cases be moved from stage IB to stage IIA, T2a N1 M0 cases from stage IIB to stage IIA, and T4 N0–1 M0 cases from stage IIIB to stage IIIA. Conclusions: Such changes, if accepted, will involve a reassessment of existing treatment algorithms. However, they are based on an intensive and validated analysis of the largest database to date. The proposed changes would improve the alignment of TNM stage with prognosis and, in certain subsets, with treatment.

Subfields: Oncology, Pulmonary and Respiratory Medicine

View Paper: https://www.semanticscholar.org/paper/02c520520cdf3bc96f9e60e2bd1c901ed21ba52d

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In Oncology

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Citations in the corpus

• A Multidimensional Index and Staging System for Idiopathic Pulmonary Fibrosis (2012, background): “Staging systems have proven useful in estimating prognosis and guiding management decisions in other lung diseases, such as asthma (6), chronic obstructive pulmonary disease (7), and lung cancer (8).”
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• The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for the Revision of the N Descriptors in the Forthcoming 8th Edition of the TNM Classification for Lung Cancer (2015, background): “This truly global, multidisciplinary effort has been termed the “IASLC Lung Cancer Staging Project”(3) and was responsible for creating the 7th edition of the TNM staging system for lung cancer.(4) The changes proposed by the IASLC were fully approved by both the UICC and the AJCC and are reflected ”
• Lung cancer: Biology and treatment options. (2015, background): “The five-year survival rate in early-stage, operable NSCLC is approximately 50%–70%, but drops to 2%–5% for patients whose cancers have spread distantly [17].”
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• Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases (2011, background): “As patients with surgically resected stage I non-small cell lung cancer have survivals of 73p for stage IA and 58p for stage IB”