The IASLC Lung Cancer Staging Project: Proposals for the Revisions of the T Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer
By R. Rami-Porta, V. Bolejack, J. Crowley, D. Ball, Jhingook Kim, G. Lyons, T. Rice, Kenji Suzuki, C. Thomas, W. Travis and 1 more. Journal of Thoracic Oncology, 2007
1,085 citations recorded by the source corpus.
Introduction: An international database was collected to inform the 8th edition of the anatomic classification of lung cancer. The present analyses concern its primary tumor (T) component. Methods: From 1999 to 2010, 77,156 evaluable patients, 70,967 with non–small-cell lung cancer, were collected; and 33,115 had either a clinical or a pathological classification, known tumor size, sufficient T information, and no metastases. Survival was measured from date of diagnosis or surgery for clinically and pathologically staged tumors. Tumor-size cutpoints were evaluated by the running log-rank statistics. T descriptors were evaluated in a multivariate Cox regression analysis adjusted for age, gender, histological type, and geographic region. Results: The 3-cm cutpoint significantly separates T1 from T2. From 1 to 5 cm, each centimeter separates tumors of significantly different prognosis. Prognosis of tumors greater than 5 cm but less than or equal to 7 cm is equivalent to T3, and that of those greater than 7 cm to T4. Bronchial involvement less than 2 cm from carina, but without involving it, and total atelectasis/pneumonitis have a T2 prognosis. Involvement of the diaphragm has a T4 prognosis. Invasion of the mediastinal pleura is a descriptor seldom used. Conclusions: Recommended changes are as follows: to subclassify T1 into T1a (⩽1 cm), T1b (>1 to ⩽2 cm), and T1c (>2 to ⩽3 cm); to subclassify T2 into T2a (>3 to ⩽4 cm) and T2b (>4 to ⩽5 cm); to reclassify tumors greater than 5 to less than or equal to 7 cm as T3; to reclassify tumors greater than 7 cm as T4; to group involvement of main bronchus as T2 regardless of distance from carina; to group partial and total atelectasis/pneumonitis as T2; to reclassify diaphragm invasion as T4; and to delete mediastinal pleura invasion as a T descriptor.
Subfields: Oncology, Pulmonary and Respiratory Medicine
View Paper: https://www.semanticscholar.org/paper/aa0bd93ede9a50784c840f1f3e74d27360c62720
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In Pulmonary and Respiratory Medicine
Citations in the corpus
- Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. (2017, neutral): “Invasion of the diaphragm was found to have a similar prognosis as other T4 tumours and has therefore been added to this category [31].”
- The IASLC Lung Cancer Staging Project: Proposals for Coding T Categories for Subsolid Nodules and Assessment of Tumor Size in Part‐Solid Tumors in the Forthcoming Eighth Edition of the TNM Classification of Lung Cancer (2016, background): “outcome in lung cancer, causing it to be one of the key elements of TNM staging.(34,35) It has been shown to be an independent predictor of survival in many publications, including in large databases such as those assembled by the National Cancer Institute’s Surveillance, Epidemiology, and End Resul”
- The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer (2016, methodology): “Candidate proposals for overall TNM stage groups were developed in conjunction with proposed changes to the T and M categories.(16,17) The proposed changes are highlighted in the full list of T, N, and M descriptors shown in Table 1, which also incorporates the subsequent recommendations of the IASL”