The IASLC lung cancer staging project: Validation of the proposals for revision of the T, N, and M descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours
The IASLC lung cancer staging project: Validation of the proposals for revision of the T, N, and M descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours
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DOI：
10.1097/jto.0b013e31812d05d5
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发表时间：
2007-08-01
影响因子：
20.4
通讯作者：
Goldstraw, Peter
中科院分区：
文献类型：
--
作者：
Groome, Patti A.;Bolejack, Vanessa;Goldstraw, Peter
简介：1996年，国际肺癌研究协会（IASLC）发起了一项全球TNM分期项目，为下一版（第七版）TNM肺癌分期系统提供信息。在这篇文章中，我们描述了所使用的方法和验证方法，并讨论了内部和外部的有效性的建议changes.Methods：国际分期委员会同意了一些指导决策过程的一般原则。通过目视评估Kaplan-Meier曲线在数据库类型、地理区域之间的一致性，以及通过评估使用基于人群的监测流行病学和最终结果癌症登记数据生成的曲线与使用项目数据库生成的曲线的相似性，解决外部有效性，解决内部有效性。考克斯比例风险回归被用来计算与调整细胞类型，性别，年龄和region.Results的建议阶段分组之间的风险比：呼吁由国际分期委员会的数据导致创建一个国际数据库，包含超过10万例的信息。本研究基于对67，725例非小细胞肺癌病例的分析。验证检查是稳健的，表明建议的阶段更改在使用的数据源内和外部都是稳定的。例如，建议的变化基于肿瘤大小得到了很好的支持，具有统计学意义的危险比范围从1.14到1.51之间的相邻对的监测流行病学和最终结果data.Conclusions：肺癌分期的定义从来没有受到这样一个激烈的验证过程。然而，我们承认，这项工作是有限的，只能通过我们打算开发的未来数据库来解决。与此同时，我们认为，这一新系统将大大提高TNM肺分期在其所有目的方面的有用性。
Introduction: In 1996, the International Association for the Study of Lung Cancer (IASLC) launched a worldwide TNM staging project to inform the next edition (seventh) of the TNM lung cancer staging system. In this article, we describe the methods and validation approaches used and discuss the internal and external validity of the recommended changes.Methods: The International Staging Committee agreed on a number of general principles that guided the decision-making process. Internal validity was addressed by visually assessing the consistency of Kaplan-Meier curves across database types, geographic regions and addressing external validity, by assessing the similarity of curves generated using the population-based Surveillance Epidemiology and End Results cancer registry data to those generated using the project database. Cox proportional hazards regression was used to calculate hazard ratios between the proposed stage groupings with adjustment for cell type, sex, age, and region.Results: Calls for data by the International Staging Committee resulted in the creation of an international database containing information on more than 100,000 cases. The present work is based on analyses of the 67,725 cases of non-small cell lung cancer. Validation checks were robust, demonstrating that the suggested staging changes are stable within the data sources used and externally. For example, suggested changes based on tumor size were well supported, with statistically significant hazard ratios ranging from 1.14 to 1.51 between adjacent pairs in the Surveillance Epidemiology and End Results data.Conclusions: Lung cancer stage definitions have never been subjected to such an intense validation process. We do accept, however, that this work is limited in ways that can only be addressed by a prospective database, which we intend to develop. In the meantime, we think that this new system will greatly improve the usefulness of TNM lung staging across all of its purposes.