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. 2024 May;19(5):749-765.
doi: 10.1016/j.jtho.2023.12.006. Epub 2023 Dec 7.

The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for the Revisions of the T-Descriptors in the Forthcoming Ninth Edition of the TNM Classification for Lung Cancer

Paul E Van Schil  1 , Hisao Asamura  2 , Katherine K Nishimura  3 , Ramon Rami-Porta  4 , Young Tae Kim  5 , Pietro Bertoglio  6 , Ayten K Cangir  7 , Jessica Donington  8 , Wentao Fang  9 , Dorothy J Giroux  3 , Yolande Lievens  10 , Hui Liu  11 , Gustavo Lyons  12 , Shuji Sakai  13 , William D Travis  14 , Paula Ugalde  15 , Chi-Fu Jeffrey Yang  16 , Masaya Yotsukura  17 , Frank Detterbeck  18 ; Members of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Boards and Participating Institutions
Affiliations

The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for the Revisions of the T-Descriptors in the Forthcoming Ninth Edition of the TNM Classification for Lung Cancer

Paul E Van Schil et al. J Thorac Oncol. 2024 May.

Abstract

Introduction: An international database was created by the International Association for the Study of Lung Cancer to inform on the ninth edition of the TNM classification of lung cancer. The present analyses concern its T component.

Methods: Data on 124,581 patients diagnosed with lung cancer from January 1, 2011 to December 31, 2019 were submitted to the International Association for the Study of Lung Cancer database. Of these, 33,982 met the inclusion criteria for the clinical T analysis, and 30,715 met the inclusion criteria for the pathologic postsurgical analysis. Survival was measured from the date of diagnosis or operation for clinically and pathologically staged tumors, respectively. T descriptors were evaluated in univariate analysis and multivariable Cox regression analysis adjusted for age, sex, pathologic type, and geographic region.

Results: Comprehensive survival analysis revealed that the existing eighth edition T component criteria performed adequately in the ninth edition data set. Although pathologic chest wall or parietal pleura involvement (PL 3) yielded a worse survival compared with the other T3 descriptors, with a similar survival as T4 tumors, this difference was not observed for clinical chest wall or PL 3 tumors. Because of these inconsistent findings, no reallocation of chest wall or PL 3 tumors is advised.

Conclusions: The T subcommittee members proposed not to implement any changes and keep the current eighth-edition T descriptors for the ninth edition.

Keywords: Lung cancer; Lung cancer staging; T-component; T-descriptors; TNM classification.

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Figures

Figure 1A and 1B.
Figure 1A and 1B.
Survival curves for the different T-categories to validate the 8th edition criteria for M0,N0, any R cases (clinical staging, left panel; pathological staging, right panel).
Figure 2A and 2B.
Figure 2A and 2B.
Survival curves for the different T-categories to validate the 8th edition criteria for R0 cases only ( clinical staging, left panel; pathological staging, right panel).
Figure 3A and 3B.
Figure 3A and 3B.
Survival curves according to the 8th edition criteria for patients with clinically staged T3 tumors with any nodal involvement (left panel) and N0 only (right panel)
Figure 4A and 4B.
Figure 4A and 4B.
Survival curves according to the 8th edition criteria for patients with pathologically staged T3 tumors with any nodal involvement (left panel) and N0 only (right panel)
See this image and copyright information in PMC

References

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