The IASLC lung cancer staging project: Proposals for the revision of he TNM stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours
The IASLC lung cancer staging project: Proposals for the revision of he TNM stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours
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DOI：
10.1097/jto.0b013e31812f3c1a
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发表时间：
2007-08-01
影响因子：
20.4
通讯作者：
Sobin, Leslie
中科院分区：
文献类型：
--
作者：
Goldstraw, Peter;Crowley, John;Sobin, Leslie
导言：《恶性肿瘤TNM分类》第七版将于2009年初出版。为了做好准备，国际肺癌研究协会于1998年建立了肺癌分期项目。该委员会关于更改T、N和M描述符的建议已经公布。这份报告包含了对新阶段分组的建议。方法：数据来自19个以上国家的46个来源。1990至2000年间，有关于67,725例非小细胞肺癌患者接受各种护理治疗的充分数据。对T、N和M描述符的更改建议被合并到TNM子集中。结果：建议包括肿瘤大小的更多分界点，肿瘤7厘米从T2转移到T3；在某些位置重新分配给其他肺结节的类别；将胸腔积液重新分类为M描述符。此外，建议将T2b非MO病例从IB期转移到IIA期，将T2a NI MO病例从第1113期转移到IIA期，将T4 NO-I MO病例从11113期转移到IIIA期。结论：如果这些变化被接受，将涉及对现有治疗算法的重新评估。然而，它们是基于对迄今为止最大的数据库进行的密集和经过验证的分析。拟议的改变将改善TNM分期与预后的一致性，在某些亚组中，将改善与治疗的一致性。
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 NO MO cases be moved from stage IB to stage IIA, T2a NI MO cases from stage 1113 to stage IIA, and T4 NO-I MO cases from stage 11113 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.