The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for the Revision of the Clinical and Pathologic Staging of Small Cell Lung Cancer in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer
Andrew G Nicholson, Kari Chansky, John Crowley, Ricardo Beyruti, Kaoru Kubota, Andrew Turrisi, Wilfried E E Eberhardt, Jan van Meerbeeck, Ramón Rami-Porta, Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions, 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, Toni 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, 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, Andrew G Nicholson, Kari Chansky, John Crowley, Ricardo Beyruti, Kaoru Kubota, Andrew Turrisi, Wilfried E E Eberhardt, Jan van Meerbeeck, Ramón Rami-Porta, Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions, 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, Toni 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, 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: Small cell lung cancer (SCLC) is commonly classified as either limited or extensive, but the Union for International Cancer Control TNM Classification of Malignant Tumours seventh edition (2009) recommended tumor, node, and metastasis (TNM) staging based on analysis of the International Association for the Study of Lung Cancer (IASLC) database.
Methods: Survival analyses were performed for clinically and pathologically staged patients presenting with SCLC from 1999 through 2010. Prognosis was compared in relation to the TNM seventh edition staging to serve as validation and analyzed in relation to proposed changes to the T descriptors found in the eighth edition.
Results: There were 5002 patients: 4848 patients with clinical and 582 with pathological stages. Among these, 428 had both. Survival differences were confirmed for T and N categories and maintained in relation to proposed revisions to T descriptors for seventh edition TNM categories and proposed changes in the eighth edition. There were also survival differences, notably at 12 months, in patients with brain-only single-site metastasis (SSM) compared to SSM at other sites, and SSM without a pleural effusion showed a better prognosis than other patients in the M1b category.
Conclusion: We confirm the prognostic value of clinical and pathological TNM staging in patients with SCLC, and recommend continued usage for SCLC in relation to proposed changes to T, N, and M descriptors for NSCLC in the eighth edition. However, for M descriptors, it remains uncertain whether survival differences in patients with SSM in the brain simply reflect better treatment options rather than better survival based on anatomic extent of disease.
Keywords: Lung cancer; Lung cancer staging; Small cell lung cancer; TNM classification.
Copyright © 2015 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.
Source: PubMed