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The IASLC Lung Cancer Staging Project: Background Data and Proposals for the Classification of Lung Cancer with Separate Tumor Nodules in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer

2016; Elsevier BV; Volume: 11; Issue: 5 Linguagem: Inglês

10.1016/j.jtho.2015.12.114

1556-1380

Frank C. Detterbeck, Vanessa Bolejack, Douglas A. Arenberg, John Crowley, Jessica Donington, Wilbur A. Franklin, Nicolas Girard, Edith M. Marom, Peter J. Mazzone, Andrew G. Nicholson, Valerie W. Rusch, L.T. Tanoue, William D. Travis, Hisao Asamura, Ramón Rami‐Porta, Peter Goldstraw, Ramón Rami‐Porta, Hisao Asamura, David Ball, David G. Beer, R. Guijarro, Vanessa Bolejack, Kari Chansky, John Crowley, Frank C. Detterbeck, Wilfried Eberhardt, John Edwards, Françoise Galateau-Sallé, Dorothy J. Giroux, Fergus Gleeson, Patti A. Groome, James Huang, Catherine Kennedy, Young Tae Kim, Young Tae Kim, Laura Kingsbury, Haruhiko Kondo, Mark Krasnik, Kaoru Kubota, Antoon Lerut, Gustavo Lyons, Mirella Marino, Edith M. Marom, Jan P. van Meerbeeck, Alan Mitchell, Takashi Nakano, Andrew G. Nicholson, Anna K. Nowak, Michael Peake, Thomas W. Rice, Kenneth E. Rosenzweig, Enrico Ruffini, Valerie W. Rusch, Nagahiro Saijo, Paul Van Schil, Jean‐Paul Sculier, Lynn Shemanski, Kelly Stratton, Kenji Suzuki, Yuji Tachimori, Charles F. Thomas, William D. Travis, Ming‐Sound Tsao, Andrew Turrisi, Johan Vansteenkiste, Hirokazu Watanabe, Yi‐Long Wu, Paul Baas, Jeremy Erasmus, Seiki Hasegawa, Kouki Inai, Kemp Kernstine, Hedy L. Kindler, Lee M. Krug, Kristiaan Nackaerts, Harvey I. Pass, David C. Rice, Conrad Falkson, Pier Luigi Filosso, Giuseppe Giaccone, Kazuya Kondo, Marco Lucchi, Meinoshin Okumura, Eugene H. Blackstone, Jeremy Erasmus, Douglas B. Flieder, Myrna C. B. Godoy, Jin Mo Goo, Lawrence R. Goodman, Jim Jett, Paul De Leyn, Alberto M. Marchevsky, Heber MacMahon, David P. Naidich, Morohito Okada, Marina Perlman, Charles A. Powell, Paul Van Schil, Ming‐Sound Tsao, Arne Warth, F. Abad Cavaco, Emilio Ansótegui Barrera, J. Abal Arca, Isaura Parente Lamelas, A. Arnau Obrer, R. Guijarro, David Ball, G.K. Bascom, Ana Isabel Blanco Orozco, M.A. González Castro, Matthew G. Blum, Domingo Chimondeguy, Vlado Cvijanović, Sebastián Defranchi, B. de Olaiz Navarro, I. Escobar Campuzano, Iván Macı́a, E. Fernández Araujo, F. Andreo García, Kwun M. Fong, Gloria Francisco Corral, S. Cerezo González, J. Freixinet Gilart, L. García Arangüena, S. García Barajas, Philippe Girard, Tuncay Göksel, M.T. González Budiño, Guillermo González Casaurrán, José Antonio Gullón Blanco, Jesús Hernández Hernández, H. Hernández Rodríguez, J. Herrero Collantes, M. Iglesias Heras, José Miguel Izquierdo Elena, Erik Jakobsen, S. Kostas, Pablo León Atance, Ana Núñez Ares, M. Liao, M. Losanovscky, Gustavo Lyons, R. Magaroles, L. De Esteban Júlvez, M. Mariñán Gorospe, Brian C. McCaughan, Catherine Kennedy, Rosario Melchor Íñiguez, Luis Miravet Sorribes, S. Naranjo Gozalo, C. Álvarez de Arriba, M. Núñez Delgado, J. Padilla Alarcón, Juan Carlos Peñalver Cuesta, J.S. Park, Harvey I. Pass, M.J. Pavón Fernández, M Rosenberg, Enrico Ruffini, Valerie W. Rusch, Julio Sánchez de Cos Escuín, A. Saura Vinuesa, M. Serra Mitjans, Trond‐Eirik Strand, Dragan Subotic, Stephen G. Swisher, Ricardo Mingarini Terra, C. Thomas, Kurt G. Tournoy, Paul Van Schil, Mauricio Velásquez, Yi‐Long Wu, K. Yokoi,

Metastasis and carcinoma case studies

IntroductionSeparate tumor nodules with the same histologic appearance occur in the lungs in a small proportion of patients with primary lung cancer. This article addresses how such tumors can be classified to inform the eighth edition of the anatomic classification of lung cancer. Separate tumor nodules should be distinguished from second primary lung cancer, multifocal ground glass/lepidic tumors, and pneumonic-type lung cancer, which are addressed in separate analyses.MethodsSurvival of patients with separate tumor nodules in the International Association for the Study of Lung Cancer database were analyzed. This was compared with a systematic literature review.ResultsSurvival of clinically staged patients decreased according to the location of the separate tumor nodule relative to the index tumor (same lobe > same side > other side) in N0 and N-any cohorts (all M0 except possible other-side nodules). However, there was also a decrease in the proportion of patients resected; among only surgically resected or among nonresected patients no survival differences were noted. There were no survival differences between patients with same-lobe nodules and those with other T3 tumors, between patients with same-side nodules and those with T4 tumors, and patients with other-side nodules and those with other M1a tumors. The data correlated with those identified in a literature review.ConclusionsTumors with same-lobe separate tumor nodules (with the same histologic appearance) are recommended to be classified as T3, same-side nodules as T4, and other-side nodules as M1a. Thus, there is no recommended change between the seventh and eighth edition of the TNM classification of lung cancer.