The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for the Revision of the Clinical and Pathologic Staging of Small Cell Lung Cancer in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer

Andrew G. Nicholson, Kari Chansky, John Crowley, Ricardo Beyruti, Kaoru Kubota, Andrew Turrisi, Wilfried E E Eberhardt, Jan Van Meerbeeck, Ramón Rami-Porta, Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions, Mirella Marino

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Abstract

INTRODUCTION: Small cell lung cancer (SCLC) is commonly classified as either limited or extensive, but the Union for International Cancer Control TNM Classification of Malignant Tumours seventh edition (2009) recommended tumor, node, and metastasis (TNM) staging based on analysis of the International Association for the Study of Lung Cancer (IASLC) database.

METHODS: Survival analyses were performed for clinically and pathologically staged patients presenting with SCLC from 1999 through 2010. Prognosis was compared in relation to the TNM seventh edition staging to serve as validation and analyzed in relation to proposed changes to the T descriptors found in the eighth edition.

RESULTS: There were 5002 patients: 4848 patients with clinical and 582 with pathological stages. Among these, 428 had both. Survival differences were confirmed for T and N categories and maintained in relation to proposed revisions to T descriptors for seventh edition TNM categories and proposed changes in the eighth edition. There were also survival differences, notably at 12 months, in patients with brain-only single-site metastasis (SSM) compared to SSM at other sites, and SSM without a pleural effusion showed a better prognosis than other patients in the M1b category.

CONCLUSION: We confirm the prognostic value of clinical and pathological TNM staging in patients with SCLC, and recommend continued usage for SCLC in relation to proposed changes to T, N, and M descriptors for NSCLC in the eighth edition. However, for M descriptors, it remains uncertain whether survival differences in patients with SSM in the brain simply reflect better treatment options rather than better survival based on anatomic extent of disease.

Original languageEnglish
Pages (from-to)300-11
Number of pages12
JournalJournal of Thoracic Oncology
Volume11
Issue number3
DOIs
Publication statusPublished - Mar 2016

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Keywords

  • Humans
  • Lung Neoplasms
  • Neoplasm Staging
  • Prognosis
  • Small Cell Lung Carcinoma
  • Survival Analysis
  • Journal Article

Cite this

Nicholson, A. G., Chansky, K., Crowley, J., Beyruti, R., Kubota, K., Turrisi, A., Eberhardt, W. E. E., Van Meerbeeck, J., Rami-Porta, R., Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions, & Marino, M. (2016). The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for the Revision of the Clinical and Pathologic Staging of Small Cell Lung Cancer in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer. Journal of Thoracic Oncology, 11(3), 300-11. https://doi.org/10.1016/j.jtho.2015.10.008