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
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
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DOI：
10.1016/j.jtho.2015.10.008
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发表时间：
2016-03-01
影响因子：
20.4
通讯作者：
Rami-Porta, Ramon
中科院分区：
文献类型：
--
作者：
Nicholson, Andrew G.;Chansky, Kari;Rami-Porta, Ramon
简介：小细胞肺癌（Small cell lung cancer， SCLC）通常分为局限性和广泛性两种，但国际癌症控制联盟（Union for International cancer Control）恶性肿瘤分类第七版（2009）在分析国际肺癌研究协会（IASLC）数据库的基础上，推荐了肿瘤、淋巴结和转移（TNM）的分期。方法：从1999年到2010年，对临床和病理分期的SCLC患者进行生存分析。将预后与TNM第七版分期进行比较，作为验证，并分析与第八版中发现的T描述符的拟议变化有关的预后。结果：共5002例患者，临床分期4848例，病理分期582例。其中，428人两者都有。T和N类的生存差异得到了证实，并与第七版TNM分类中T描述符的拟议修订和第八版TNM分类中拟议的修改有关。与其他部位的SSM相比，仅脑单部位转移（SSM）患者的生存期也存在差异，特别是在12个月时，无胸膜积液的SSM患者的预后优于M1b类别的其他患者。结论：我们确认了临床和病理TNM分期在SCLC患者中的预后价值，并建议SCLC继续使用第八版中对NSCLC的T， N和M描述符的修改。然而，对于M描述符，尚不确定脑SSM患者的生存差异是否仅仅反映了更好的治疗方案，而不是基于疾病解剖程度的更好的生存。(C) 2015年国际肺癌研究协会。Elsevier Inc.出版。版权所有。
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. (C) 2015 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.