Implications of the Eighth Edition of the TNM Proposal: Invasive Versus Total Tumor Size for the T Descriptor in Pathologic Stage I-IIA Lung Adenocarcinoma.
Implications of the Eighth Edition of the TNM Proposal: Invasive Versus Total Tumor Size for the T Descriptor in Pathologic Stage I-IIA Lung Adenocarcinoma.
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DOI：
10.1016/j.jtho.2018.08.2022
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Travis WD
中科院分区：
文献类型：
--
作者：
Kameda K;Eguchi T;Lu S;Qu Y;Tan KS;Kadota K;Adusumilli PS;Travis WD
第八版肿瘤、淋巴结和转移（TNM）分期系统包括根据浸润性成分确定T描述符的建议，不包括浸润性成分，对于非粘液性肺腺癌。我们试图对新提出的浸润大小与肿瘤总大小的分类进行临床病理比较分析。回顾性分析了病理分期为（p期）I-IIA（基于总大小[t]）的原发性肺腺癌行肺切除术的患者（n=1704）。测量病理浸润大小，并使用浸润大小(i)对肿瘤进行重新分类。使用竞争风险法分析累积复发率（CIR）和肺癌特异性累积死亡发生率（LC-CID）。使用一致性指数（C-index）评估p期(t)和p期(i)的预后区分。1704例患者中有377例（22%）采用有创取尺术导致分期降低，p期IA1患者是p期IA1患者的两倍（IA1[i]对IA1[t]: 389[23%]对195[11%]）。然而，两组之间的结果相似（IA1[i] vs IA1[t]: 5年cir， 11% vs 13%； 5年LC-CID， 5% vs 7%）。p-Stage(i)对预后的鉴别优于p-Stage(t) （p-Stage[i]与p-Stage[t]的c指数：复发，0.614比0.593；肺癌特异性死亡，0.634比0.621）。当使用浸润大小而不是总大小作为T描述符时，更多的患者被分类为预后良好（p期IA1），并且p期I-IIA非粘液肺腺癌的预后更好。
The eighth edition of the tumor, node, and metastasis (TNM) staging system included the proposal that the T descriptor be determined according to the invasive component, excluding lepidic component, for nonmucinous lung adenocarcinomas. We sought to conduct a clinicopathologic comparative analysis of the newly proposed classification using invasive size versus total tumor size. Patients who underwent lung resection for primary lung adenocarcinoma with pathologic stage (p-Stage) I-IIA (based on total size [t]) were reviewed (n=1704). Pathologic invasive size was measured, and tumors were reclassified using invasive size (i). Cumulative incidence of recurrence (CIR) and lung cancer–specific cumulative incidence of death (LC-CID) were analyzed using a competing-risks approach. Prognostic discrimination by p-Stage(t) and p-Stage(i) was evaluated using a concordance index (C-index). The use of invasive size resulted in downstaging in 377 of 1704 patients (22%), with twice as many patients with p-Stage IA1 (IA1[i] vs. IA1[t]: 389 [23%] vs. 195 [11%]). However, outcomes were similar between the two groups (IA1[i] vs. IA1[t]: 5-year-CIR, 11% vs. 13%; 5-year LC-CID, 5% vs. 7%). Prognostic discrimination by p-Stage(i) was better than by p-Stage(t) (C-index for p-Stage[i] vs. p-Stage[t]: recurrence, 0.614 vs. 0.593; lung cancer–specific death, 0.634 vs. 0.621). When invasive size, rather than total size, was used for the T descriptor, a larger number of patients were classified with a favorable prognosis (p-Stage IA1) and better prognostic discrimination of p-Stage I-IIA nonmucinous lung adenocarcinomas was achieved.
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DOI：
10.1097/pas.0b013e318190157c
发表时间：
2009-03
期刊：
The American journal of surgical pathology
影响因子：
--
作者：
Borczuk AC;Qian F;Kazeros A;Eleazar J;Assaad A;Sonett JR;Ginsburg M;Gorenstein L;Powell CA
通讯作者：
Powell CA
DOI：
10.1097/pas.0b013e3181b8cf03
发表时间：
2009-12
期刊：
The American journal of surgical pathology
影响因子：
--
作者：
Girard N;Deshpande C;Lau C;Finley D;Rusch V;Pao W;Travis WD
通讯作者：
Travis WD
影响因子：
3.3
作者：
Boland, Jennifer M.;Froemming, Adam T.;Yi, Eunhee S.
通讯作者：
Yi, Eunhee S.
影响因子：
20.4
作者：
Goldstraw, Peter;Chansky, Kari;Bolejack, Vanessa
通讯作者：
Bolejack, Vanessa
DOI：
10.1016/j.jtcvs.2013.04.032
发表时间：
2013-09-01
影响因子：
6
作者：
Tsutani, Yasuhiro;Miyata, Yoshihiro;Okada, Morihito
通讯作者：
Okada, Morihito