The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Application and interpretation of the residual tumor classification for lung cancer—Results from an international survey among pathologists and thoracic surgeons Journal Article


Authors: Hoffmann, H.; Nicholson, A. G.; Detterbeck, F. C.; Tsao, M. S.; Ostrowski, M.; Rami-Porta, R.; Borczuk, A.; Marino, M.; Travis, W. D.; Van Schil, P. E.; Edwards, J.; the Members of the R-Subcommittee; the IASLC Staging and Prognostic Factors Committee, and the Advisory Boards
Article Title: The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Application and interpretation of the residual tumor classification for lung cancer—Results from an international survey among pathologists and thoracic surgeons
Abstract: Objectives: The study aimed to assess the opinion of pathologists and thoracic surgeons of the International Association for the Study of Lung Cancer regarding the application and interpretation of the residual tumor (R) classification for lung cancer. Methods: On the basis of their membership profiles, a total of 623 pathologists and thoracic surgeons were identified and contacted by email with a cover letter and a link to an online survey. The questionnaire consisted of 12 questions about various aspects of the application and interpretation of the R classification for lung cancer. The response rate (to at least one question) was 72% (144 pathologists and 303 surgeons). Results: The frequency of use of the R classification varies by geographic region. Although R status is regularly reported in Europe and Asia, 70% of pathologists in the United States and Canada never include R status in reports. Similar variations exist about who assigns the R category for the resection—in Europe and the United Kingdom, it is mainly the pathologist, whereas in China, Japan and the United States, it is the surgeon. There are some good agreements about margins examined and how to manage staple lines. The category “uncertain resection” has not been practically implemented in most of the world, except at some centers in Japan and the United Kingdom. Conclusion: This survey shows that surgical resection margins are part of routine reporting in most institutions; but the assignment of an R category is not always part of the pathology report, with considerable variation between countries. Despite the International Association for the Study of Lung Cancer proposals, the application of the uncertain resection category has not been taken up by most institutions, and further evidence is needed. © 2024 International Association for the Study of Lung Cancer
Keywords: cancer staging; neoplasm staging; classification; lung neoplasms; lung cancer; pathology; distant metastasis; questionnaire; lung tumor; minimal residual disease; neoplasm, residual; lymph node; surgeon; surgery; thorax surgery; pathologist; residual disease; surgical margin; surgeons; thoracic surgery; pathologists; geographical variation (species); complete resection; humans; human; article; surveys and questionnaires; thoracic surgeon
Journal Title: Journal of Thoracic Oncology
Volume: 20
Issue: 5
ISSN: 1556-0864
Publisher: Elsevier Inc.  
Date Published: 2025-05-01
Start Page: 597
End Page: 613
Language: English
DOI: 10.1016/j.jtho.2024.12.007
PUBMED: 39675507
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
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  1. William D Travis
    743 Travis