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Review
. 2024 Oct;166(4):882-895.
doi: 10.1016/j.chest.2024.05.026. Epub 2024 Jun 15.

The Proposed Ninth Edition TNM Classification of Lung Cancer

Frank C Detterbeck  1 , Gavitt A Woodard  2 , Anna S Bader  3 , Sanja Dacic  4 , Michael J Grant  5 , Henry S Park  6 , Lynn T Tanoue  7
Affiliations
Review

The Proposed Ninth Edition TNM Classification of Lung Cancer

Frank C Detterbeck et al. Chest. 2024 Oct.

Abstract

A universal nomenclature of the anatomic extent of lung cancer has been critical for individual patient care as well as research advances. As progress occurs, new details emerge that need to be included in a refined system that aligns with contemporary clinical management issues. The ninth edition TNM classification of lung cancer, which is scheduled to take effect in January 2025, addresses this need. It is based on a large international database, multidisciplinary input, and extensive statistical analyses. Key features of the ninth edition include validation of the significant changes in the T component introduced in the eighth edition, subdivision of N2 after exploration of fundamentally different ways of categorizing the N component, and further subdivision of the M component. This has led to reordering of the TNM combinations included in stage groups, primarily involving stage groups IIA, IIB, IIIA, and IIIB. This article summarizes the analyses and revisions for the TNM classification of lung cancer to familiarize the broader medical community and facilitate implementation of the ninth edition system.

Keywords: TNM classification; lung cancer; stage groups.

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Conflict of interest statement

Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: M. J. G. reports honoraria from AstraZeneca, Daiichi Sanyo, and Regeneron (all unrelated to the topic). H. S. P. reports institutional grants from RefleXion and Merck; and consulting fees from RefleXion and AstraZeneca. S. D. reports honoraria from AstraZeneca and Medscape; and is the chair of the IASLC pathology committee. G. A. W. reports grants from the American Cancer Society and the International Lung Cancer Foundation; a career enhancement grant from the Yale SPORE in lung cancer; and consulting fees from AstraZeneca. None declared: (F. C. D., A. S. B., L. T. T.).