The IASLC Lung Cancer Staging Project: External Validation of the Revision of the TNM Stage Groupings in the Eighth Edition of the TNM Classification of Lung Cancer
Kari Chansky, Frank C Detterbeck, Andrew G Nicholson, Valerie W Rusch, Eric Vallières, Patti Groome, Catherine Kennedy, Mark Krasnik, Michael Peake, Lynn Shemanski, Vanessa Bolejack, John J Crowley, Hisao Asamura, Ramón Rami-Porta, IASLC Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions, Peter Goldstraw, Ramón Rami-Porta, Hisao Asamura, David Ball, David G Beer, Ricardo Beyruti, Vanessa Bolejack, Kari Chansky, John Crowley, Frank Detterbeck, Wilfried Ernst Erich Eberhardt, John Edwards, Françoise Galateau-Sallé, Dorothy Giroux, Fergus Gleeson, Patti Groome, James Huang, Catherine Kennedy, Jhingook Kim, Young Tae Kim, Laura Kingsbury, Haruhiko Kondo, Mark Krasnik, Kaoru Kubota, Antoon Lerut, Gustavo Lyons, Mirella Marino, Edith M Marom, Jan van Meerbeeck, Alan Mitchell, Takashi Nakano, Andrew G Nicholson, Anna Nowak, Michael Peake, Thomas Rice, Kenneth Rosenzweig, Enrico Ruffini, Valerie Rusch, Nagahiro Saijo, Paul Van Schil, Jean-Paul Sculier, Lynn Shemanski, Kelly Stratton, Kenji Suzuki, Yuji Tachimori, Charles F Thomas Jr, William Travis, Ming S Tsao, Andrew Turrisi, Johan Vansteenkiste, Hirokazu Watanabe, Yi-Long Wu, Paul Baas, Jeremy Erasmus, Seiki Hasegawa, Kouki Inai, Kemp Kernstine, Hedy Kindler, Lee Krug, Kristiaan Nackaerts, Harvey Pass, David Rice, Conrad Falkson, Pier Luigi Filosso, Giuseppe Giaccone, Kazuya Kondo, Marco Lucchi, Meinoshin Okumura, Eugene Blackstone, F Abad Cavaco, E Ansótegui Barrera, J Abal Arca, I Parente Lamelas, A Arnau Obrer, R Guijarro Jorge, D Ball, G K Bascom, A I Blanco Orozco, M A González Castro, M G Blum, D Chimondeguy, V Cvijanovic, S Defranchi, B de Olaiz Navarro, I Escobar Campuzano, I Macía Vidueira, E Fernández Araujo, F Andreo García, K M Fong, G Francisco Corral, S Cerezo González, J Freixinet Gilart, L García Arangüena, S García Barajas, P Girard, T Goksel, M T González Budiño, G González Casaurrán, J A Gullón Blanco, J Hernández Hernández, H Hernández Rodríguez, J Herrero Collantes, M Iglesias Heras, J M Izquierdo Elena, E Jakobsen, S Kostas, P León Atance, A Núñez Ares, M Liao, M Losanovscky, G Lyons, R Magaroles, L De Esteban Júlvez, M Mariñán Gorospe, B McCaughan, C Kennedy, R Melchor Íñiguez, L Miravet Sorribes, S Naranjo Gozalo, C Álvarez de Arriba, M Núñez Delgado, J Padilla Alarcón, J C Peñalver Cuesta, J S Park, H Pass, M J Pavón Fernández, M Rosenberg, E Ruffini, V Rusch, J Sánchez de Cos Escuín, A Saura Vinuesa, M Serra Mitjans, T E Strand, D Subotic, S Swisher, R Terra, C Thomas, K Tournoy, P Van Schil, M Velasquez, Y L Wu, K Yokoi, Kari Chansky, Frank C Detterbeck, Andrew G Nicholson, Valerie W Rusch, Eric Vallières, Patti Groome, Catherine Kennedy, Mark Krasnik, Michael Peake, Lynn Shemanski, Vanessa Bolejack, John J Crowley, Hisao Asamura, Ramón Rami-Porta, IASLC Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions, Peter Goldstraw, Ramón Rami-Porta, Hisao Asamura, David Ball, David G Beer, Ricardo Beyruti, Vanessa Bolejack, Kari Chansky, John Crowley, Frank Detterbeck, Wilfried Ernst Erich Eberhardt, John Edwards, Françoise Galateau-Sallé, Dorothy Giroux, Fergus Gleeson, Patti Groome, James Huang, Catherine Kennedy, Jhingook Kim, Young Tae Kim, Laura Kingsbury, Haruhiko Kondo, Mark Krasnik, Kaoru Kubota, Antoon Lerut, Gustavo Lyons, Mirella Marino, Edith M Marom, Jan van Meerbeeck, Alan Mitchell, Takashi Nakano, Andrew G Nicholson, Anna Nowak, Michael Peake, Thomas Rice, Kenneth Rosenzweig, Enrico Ruffini, Valerie Rusch, Nagahiro Saijo, Paul Van Schil, Jean-Paul Sculier, Lynn Shemanski, Kelly Stratton, Kenji Suzuki, Yuji Tachimori, Charles F Thomas Jr, William Travis, Ming S Tsao, Andrew Turrisi, Johan Vansteenkiste, Hirokazu Watanabe, Yi-Long Wu, Paul Baas, Jeremy Erasmus, Seiki Hasegawa, Kouki Inai, Kemp Kernstine, Hedy Kindler, Lee Krug, Kristiaan Nackaerts, Harvey Pass, David Rice, Conrad Falkson, Pier Luigi Filosso, Giuseppe Giaccone, Kazuya Kondo, Marco Lucchi, Meinoshin Okumura, Eugene Blackstone, F Abad Cavaco, E Ansótegui Barrera, J Abal Arca, I Parente Lamelas, A Arnau Obrer, R Guijarro Jorge, D Ball, G K Bascom, A I Blanco Orozco, M A González Castro, M G Blum, D Chimondeguy, V Cvijanovic, S Defranchi, B de Olaiz Navarro, I Escobar Campuzano, I Macía Vidueira, E Fernández Araujo, F Andreo García, K M Fong, G Francisco Corral, S Cerezo González, J Freixinet Gilart, L García Arangüena, S García Barajas, P Girard, T Goksel, M T González Budiño, G González Casaurrán, J A Gullón Blanco, J Hernández Hernández, H Hernández Rodríguez, J Herrero Collantes, M Iglesias Heras, J M Izquierdo Elena, E Jakobsen, S Kostas, P León Atance, A Núñez Ares, M Liao, M Losanovscky, G Lyons, R Magaroles, L De Esteban Júlvez, M Mariñán Gorospe, B McCaughan, C Kennedy, R Melchor Íñiguez, L Miravet Sorribes, S Naranjo Gozalo, C Álvarez de Arriba, M Núñez Delgado, J Padilla Alarcón, J C Peñalver Cuesta, J S Park, H Pass, M J Pavón Fernández, M Rosenberg, E Ruffini, V Rusch, J Sánchez de Cos Escuín, A Saura Vinuesa, M Serra Mitjans, T E Strand, D Subotic, S Swisher, R Terra, C Thomas, K Tournoy, P Van Schil, M Velasquez, Y L Wu, K Yokoi
Abstract
Introduction: Revisions to the TNM stage classifications for lung cancer, informed by the international database (N = 94,708) of the International Association for the Study of Lung Cancer (IASLC) Staging and Prognostic Factors Committee, need external validation. The objective was to externally validate the revisions by using the National Cancer Data Base (NCDB) of the American College of Surgeons.
Methods: Cases presenting from 2000 through 2012 were drawn from the NCDB and reclassified according to the eighth edition stage classification. Clinically and pathologically staged subsets of NSCLC were analyzed separately. The T, N, and overall TNM classifications were evaluated according to clinical, pathologic, and "best" stage (N = 780,294). Multivariate analyses were carried out to adjust for various confounding factors. A combined analysis of the NSCLC cases from both databases was performed to explore differences in overall survival prognosis between the two databases.
Results: The databases differed in terms of key factors related to data source. Survival was greater in the IASLC database for all stage categories. However, the eighth edition TNM stage classification system demonstrated consistent ability to discriminate TNM categories and stage groups for clinical and pathologic stage.
Conclusions: The IASLC revisions made for the eighth edition of lung cancer staging are validated by this analysis of the NCDB database by the ordering, statistical differences, and homogeneity within stage groups and by the consistency within analyses of specific cohorts.
Keywords: AJCC; Lung cancer; National Cancer Database; Staging; UICC; Validation.
Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.
Source: PubMed