The IASLC Mesothelioma Staging Project

Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma

David Rice, Kari Chansky, Anna Nowak, Harvey Pass, Hedy Kindler, Lynn Shemanski, Isabelle Opitz, Sergi Call, Seiki Hasegawa, Kemp Kernstine, Cansel Atinkaya, Federico Rea, Philippe Nafteux, Valerie W Rusch, Mesothelioma Domain of the IASLC Staging and Prognostic Factors Committee, advisory boards and participating institutions

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Nodal categories for malignant pleural mesothelioma are derived from the lung cancer staging system and have not been adequately validated. The International Association for the Study of Lung Cancer developed a multinational database to generate evidence-based recommendations to inform the eighth edition of the TNM classification of malignant pleural mesothelioma.

METHODS: Data from 29 centers were entered prospectively (n = 1566) or by transfer of retrospective data (n = 1953). Survival according to the seventh edition N categories was evaluated using Kaplan-Meier survival curves and Cox proportional hazards regression analysis. Survival was measured from the date of diagnosis.

RESULTS: There were 2432 analyzable cases: 1603 had clinical (c) staging, 1614 had pathologic (p) staging, and 785 had both. For clinically staged tumors there was no separation in Kaplan-Meier curves between cN0, cN1 or cN2 (cN1 versus cN0 hazard ratio [HR] = 1.06, p = 0.77 and cN2 versus cN1 HR = 1.04, p = 0.85). For pathologically staged tumors, patients with pN1 or pN2 tumors had worse survival than those with pN0 tumors (HR = 1.51, p < 0.0001) but no survival difference was noted between those with pN1 and pN2 tumors (HR = 0.99, p = 0.99). Patients with both pN1 and pN2 nodal involvement had poorer survival than those with pN2 tumors only (HR = 1.60, p = 0.007) or pN0 tumors (HR = 1.62, p < 0.0001).

CONCLUSIONS: A recommendation to collapse both clinical and pN1 and pN2 categories into a single N category comprising ipsilateral, intrathoracic nodal metastases (N1) will be made for the eighth edition staging system. Nodes previously categorized as N3 will be reclassified as N2.

Original languageEnglish
Pages (from-to)2100-2111
Number of pages12
JournalJournal of Thoracic Oncology
Volume11
Issue number12
DOIs
Publication statusPublished - Dec 2016
Externally publishedYes

Fingerprint

Neoplasm Staging
Mesothelioma
Survival
Neoplasms
Kaplan-Meier Estimate
Lung Neoplasms
Regression Analysis
Databases
Neoplasm Metastasis

Keywords

  • Journal Article

Cite this

Rice, D., Chansky, K., Nowak, A., Pass, H., Kindler, H., Shemanski, L., ... Mesothelioma Domain of the IASLC Staging and Prognostic Factors Committee, advisory boards and participating institutions (2016). The IASLC Mesothelioma Staging Project: Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma. Journal of Thoracic Oncology, 11(12), 2100-2111. https://doi.org/10.1016/j.jtho.2016.09.121

The IASLC Mesothelioma Staging Project : Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma. / Rice, David; Chansky, Kari; Nowak, Anna; Pass, Harvey; Kindler, Hedy; Shemanski, Lynn; Opitz, Isabelle; Call, Sergi; Hasegawa, Seiki; Kernstine, Kemp; Atinkaya, Cansel; Rea, Federico; Nafteux, Philippe; Rusch, Valerie W; Mesothelioma Domain of the IASLC Staging and Prognostic Factors Committee, advisory boards and participating institutions.

In: Journal of Thoracic Oncology, Vol. 11, No. 12, 12.2016, p. 2100-2111.

Research output: Contribution to journalArticle

Rice, D, Chansky, K, Nowak, A, Pass, H, Kindler, H, Shemanski, L, Opitz, I, Call, S, Hasegawa, S, Kernstine, K, Atinkaya, C, Rea, F, Nafteux, P, Rusch, VW & Mesothelioma Domain of the IASLC Staging and Prognostic Factors Committee, advisory boards and participating institutions 2016, 'The IASLC Mesothelioma Staging Project: Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma', Journal of Thoracic Oncology, vol. 11, no. 12, pp. 2100-2111. https://doi.org/10.1016/j.jtho.2016.09.121
Rice, David ; Chansky, Kari ; Nowak, Anna ; Pass, Harvey ; Kindler, Hedy ; Shemanski, Lynn ; Opitz, Isabelle ; Call, Sergi ; Hasegawa, Seiki ; Kernstine, Kemp ; Atinkaya, Cansel ; Rea, Federico ; Nafteux, Philippe ; Rusch, Valerie W ; Mesothelioma Domain of the IASLC Staging and Prognostic Factors Committee, advisory boards and participating institutions. / The IASLC Mesothelioma Staging Project : Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma. In: Journal of Thoracic Oncology. 2016 ; Vol. 11, No. 12. pp. 2100-2111.
@article{d1a2f3d95ad44cbdbea4f56ef7a64698,
title = "The IASLC Mesothelioma Staging Project: Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma",
abstract = "INTRODUCTION: Nodal categories for malignant pleural mesothelioma are derived from the lung cancer staging system and have not been adequately validated. The International Association for the Study of Lung Cancer developed a multinational database to generate evidence-based recommendations to inform the eighth edition of the TNM classification of malignant pleural mesothelioma.METHODS: Data from 29 centers were entered prospectively (n = 1566) or by transfer of retrospective data (n = 1953). Survival according to the seventh edition N categories was evaluated using Kaplan-Meier survival curves and Cox proportional hazards regression analysis. Survival was measured from the date of diagnosis.RESULTS: There were 2432 analyzable cases: 1603 had clinical (c) staging, 1614 had pathologic (p) staging, and 785 had both. For clinically staged tumors there was no separation in Kaplan-Meier curves between cN0, cN1 or cN2 (cN1 versus cN0 hazard ratio [HR] = 1.06, p = 0.77 and cN2 versus cN1 HR = 1.04, p = 0.85). For pathologically staged tumors, patients with pN1 or pN2 tumors had worse survival than those with pN0 tumors (HR = 1.51, p < 0.0001) but no survival difference was noted between those with pN1 and pN2 tumors (HR = 0.99, p = 0.99). Patients with both pN1 and pN2 nodal involvement had poorer survival than those with pN2 tumors only (HR = 1.60, p = 0.007) or pN0 tumors (HR = 1.62, p < 0.0001).CONCLUSIONS: A recommendation to collapse both clinical and pN1 and pN2 categories into a single N category comprising ipsilateral, intrathoracic nodal metastases (N1) will be made for the eighth edition staging system. Nodes previously categorized as N3 will be reclassified as N2.",
keywords = "Journal Article",
author = "David Rice and Kari Chansky and Anna Nowak and Harvey Pass and Hedy Kindler and Lynn Shemanski and Isabelle Opitz and Sergi Call and Seiki Hasegawa and Kemp Kernstine and Cansel Atinkaya and Federico Rea and Philippe Nafteux and Rusch, {Valerie W} and {Mesothelioma Domain of the IASLC Staging and Prognostic Factors Committee, advisory boards and participating institutions}",
note = "Copyright {\circledC} 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.",
year = "2016",
month = "12",
doi = "10.1016/j.jtho.2016.09.121",
language = "English",
volume = "11",
pages = "2100--2111",
journal = "Journal of Thoracic Oncology",
issn = "1556-0864",
publisher = "Elsevier Inc.",
number = "12",

}

TY - JOUR

T1 - The IASLC Mesothelioma Staging Project

T2 - Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma

AU - Rice, David

AU - Chansky, Kari

AU - Nowak, Anna

AU - Pass, Harvey

AU - Kindler, Hedy

AU - Shemanski, Lynn

AU - Opitz, Isabelle

AU - Call, Sergi

AU - Hasegawa, Seiki

AU - Kernstine, Kemp

AU - Atinkaya, Cansel

AU - Rea, Federico

AU - Nafteux, Philippe

AU - Rusch, Valerie W

AU - Mesothelioma Domain of the IASLC Staging and Prognostic Factors Committee, advisory boards and participating institutions

N1 - Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

PY - 2016/12

Y1 - 2016/12

N2 - INTRODUCTION: Nodal categories for malignant pleural mesothelioma are derived from the lung cancer staging system and have not been adequately validated. The International Association for the Study of Lung Cancer developed a multinational database to generate evidence-based recommendations to inform the eighth edition of the TNM classification of malignant pleural mesothelioma.METHODS: Data from 29 centers were entered prospectively (n = 1566) or by transfer of retrospective data (n = 1953). Survival according to the seventh edition N categories was evaluated using Kaplan-Meier survival curves and Cox proportional hazards regression analysis. Survival was measured from the date of diagnosis.RESULTS: There were 2432 analyzable cases: 1603 had clinical (c) staging, 1614 had pathologic (p) staging, and 785 had both. For clinically staged tumors there was no separation in Kaplan-Meier curves between cN0, cN1 or cN2 (cN1 versus cN0 hazard ratio [HR] = 1.06, p = 0.77 and cN2 versus cN1 HR = 1.04, p = 0.85). For pathologically staged tumors, patients with pN1 or pN2 tumors had worse survival than those with pN0 tumors (HR = 1.51, p < 0.0001) but no survival difference was noted between those with pN1 and pN2 tumors (HR = 0.99, p = 0.99). Patients with both pN1 and pN2 nodal involvement had poorer survival than those with pN2 tumors only (HR = 1.60, p = 0.007) or pN0 tumors (HR = 1.62, p < 0.0001).CONCLUSIONS: A recommendation to collapse both clinical and pN1 and pN2 categories into a single N category comprising ipsilateral, intrathoracic nodal metastases (N1) will be made for the eighth edition staging system. Nodes previously categorized as N3 will be reclassified as N2.

AB - INTRODUCTION: Nodal categories for malignant pleural mesothelioma are derived from the lung cancer staging system and have not been adequately validated. The International Association for the Study of Lung Cancer developed a multinational database to generate evidence-based recommendations to inform the eighth edition of the TNM classification of malignant pleural mesothelioma.METHODS: Data from 29 centers were entered prospectively (n = 1566) or by transfer of retrospective data (n = 1953). Survival according to the seventh edition N categories was evaluated using Kaplan-Meier survival curves and Cox proportional hazards regression analysis. Survival was measured from the date of diagnosis.RESULTS: There were 2432 analyzable cases: 1603 had clinical (c) staging, 1614 had pathologic (p) staging, and 785 had both. For clinically staged tumors there was no separation in Kaplan-Meier curves between cN0, cN1 or cN2 (cN1 versus cN0 hazard ratio [HR] = 1.06, p = 0.77 and cN2 versus cN1 HR = 1.04, p = 0.85). For pathologically staged tumors, patients with pN1 or pN2 tumors had worse survival than those with pN0 tumors (HR = 1.51, p < 0.0001) but no survival difference was noted between those with pN1 and pN2 tumors (HR = 0.99, p = 0.99). Patients with both pN1 and pN2 nodal involvement had poorer survival than those with pN2 tumors only (HR = 1.60, p = 0.007) or pN0 tumors (HR = 1.62, p < 0.0001).CONCLUSIONS: A recommendation to collapse both clinical and pN1 and pN2 categories into a single N category comprising ipsilateral, intrathoracic nodal metastases (N1) will be made for the eighth edition staging system. Nodes previously categorized as N3 will be reclassified as N2.

KW - Journal Article

U2 - 10.1016/j.jtho.2016.09.121

DO - 10.1016/j.jtho.2016.09.121

M3 - Article

VL - 11

SP - 2100

EP - 2111

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

SN - 1556-0864

IS - 12

ER -