The IASLC Mesothelioma Staging Project: Proposals for Revisions of the T Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma
The IASLC Mesothelioma Staging Project: Proposals for Revisions of the T Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma
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DOI：
10.1016/j.jtho.2016.08.147
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发表时间：
2016-12-01
影响因子：
20.4
通讯作者：
Rusch, Valerie W.
中科院分区：
文献类型：
--
作者：
Nowak, Anna K.;Chansky, Kari;Rusch, Valerie W.
引言：目前恶性胸膜间皮瘤（MPM）的T成分主要来自手术数据集和共识。国际肺癌研究协会进行了修订的第七版的MPM分期系统的目标是制定建议的第八版。方法：数据元素，包括详细的T描述符的共识。还记录了三个胸膜水平的肿瘤厚度。建立了一个电子数据采集系统，以方便数据提交。结果：共有3519例提交到数据库。在符合T成分分析的患者中，509例仅具有临床分期，836例仅具有手术分期，642例两者均可用。根据现行第七版分期系统，对T分类的生存率进行了检查。除T1 a与T1 b（风险比= 0.99，p = 0.95）和T3与T4（风险比= 1.22，p = 0.09）外，所有临床分期类别之间均存在明显分离，尽管T4病例数量较少。病理分期未能证明T3与T4之间的相邻类别的生存差异。T1 a和T1 b合并为一个T1类别后，性能得到改善;没有改变或消除当前描述符。肿瘤厚度和结节状或rindlike形态显着相关survival.Conclusions：建议崩溃的临床和病理T1 a和T1 b到T1分类将第八版分期系统。胸膜厚度的简单测量具有预后意义，应进一步检查，以期纳入未来的分期。(C)2016年国际肺癌研究协会。由爱思唯尔公司出版All rights reserved.
Introduction: The current T component for malignant pleural mesothelioma (MPM) has been predominantly informed by surgical data sets and consensus. The International Association for the Study of Lung Cancer undertook revision of the seventh edition of the staging system for MPM with the goal of developing recommendations for the eighth edition.Methods: Data elements including detailed T descriptors were developed by consensus. Tumor thickness at three pleural levels was also recorded. An electronic data capture system was established to facilitate data submission.Results: A total of 3519 cases were submitted to the database. Of those eligible for T-component analysis, 509 cases had only clinical staging, 836 cases had only surgical staging, and 642 cases had both available. Survival was examined for T categories according to the current seventh edition staging system. There was clear separation between all clinically staged categories except T1a versus T1b (hazard ratio = 0.99, p = 0.95) and T3 versus T4 (hazard ratio = 1.22, p = 0.09), although the numbers of T4 cases were small. Pathological staging failed to demonstrate a survival difference between adjacent categories with the exception of T3 versus T4. Performance improved with collapse of T1a and T1b into a single T1 category; no current descriptors were shifted or eliminated. Tumor thickness and nodular or rindlike morphology were significantly associated with survival.Conclusions: A recommendation to collapse both clinical and pathological T1a and T1b into a T1 classification will be made for the eighth edition staging system. Simple measurement of pleural thickness has prognostic significance and should be examined further with a view to incorporation into future staging. (C) 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.