The IASLC Lung Cancer Staging Project: Background data and proposals for the application of TNM staging rules to lung cancer presenting as multiple nodules with ground glass or lepidic features or a pneumonic type of involvement in the forthcoming eighth edition of the TNM classification Journal Article
| Authors: | Detterbeck, F. C.; Marom, E. M.; Arenberg, D. A.; Franklin, W. A.; Nicholson, A. G.; Travis, W. D.; Girard, N.; Mazzone, P. J.; Donington, J. S.; Tanoue, L. T.; Rusch, V. W.; Asamura, H.; Rami-Porta, R.; on behalf of the IASLC Staging and Prognostic Factors Committee, Advisory Boards; Multiple Pulmonary Sites Workgroup |
| Article Title: | The IASLC Lung Cancer Staging Project: Background data and proposals for the application of TNM staging rules to lung cancer presenting as multiple nodules with ground glass or lepidic features or a pneumonic type of involvement in the forthcoming eighth edition of the TNM classification |
| Abstract: | Introduction: Application of tumor, node, and metastasis (TNM) classification is difficult in patients with lung cancer presenting as multiple ground glass nodules or with diffuse pneumonic-type involvement. Clarification of how to do this is needed for the forthcoming eighth edition ofTNMclassification. Methods: A subcommittee of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee conducted a systematic literature review to build an evidence base regarding such tumors. An iterative process that included an extended workgroup was used to develop proposals for TNM classification. Results: Patients with multiple tumors with a prominent ground glass component on imaging or lepidic component on microscopy are being seen with increasing frequency. These tumors are associated with good survival after resection and a decreased propensity for nodal and extrathoracic metastases. Diffuse pneumonic-type involvement in the lung is associated with a worse prognosis, but also with a decreased propensity for nodal and distant metastases. Conclusion: For multifocal ground glass/lepidic tumors, we propose that the T category be determined by the highest T lesion, with either the number of tumors or m in parentheses to denote the multifocal nature, and that a single N and M category be used for all the lesions collectively-for example, T1a(3)N0M0 or T1b(m)N0M0. For diffuse pneumonic-type lung cancer we propose that the T category be designated by size (or T3) if in one lobe, as T4 if involving an ipsilateral different lobe, or as M1a if contralateral and that a single N and M category be used for all pulmonary areas of involvement. © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved. |
| Keywords: | lung cancer; non-small cell lung cancer; lung cancer staging; tnm classification; multiple tumors |
| Journal Title: | Journal of Thoracic Oncology |
| Volume: | 11 |
| Issue: | 5 |
| ISSN: | 1556-0864 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2016-05-01 |
| Start Page: | 666 |
| End Page: | 680 |
| Language: | English |
| DOI: | 10.1016/j.jtho.2015.12.113 |
| PROVIDER: | scopus |
| PUBMED: | 26940527 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 July 2016 -- Source: Scopus |
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