Chest
Special FeaturesThe Eighth Edition Lung Cancer Stage Classification
Section snippets
Basic Concepts
The description of the anatomic extent of a tumor consists of three components: T for extent of the primary tumor, N for involvement of lymph nodes, and M for distant metastases. Each T, N, and M component is divided into several categories (eg, T1, T2). Various characteristics, known as descriptors, define what is included within a T, N, or M category. Specific combinations of T, N, and M categories are grouped together into stage groups.
A prefix further specifies the context of the stage
T Component
The T component analysis was on the basis of 10,230 c-stage and 22,257 p-stage tumors with sufficient detailed information.7 The impact of size was analyzed using a running log rank statistic (initially in a p-stage N0 M0 R0 non-small cell lung cancer [NSCLC] cohort, but then substantiated in multiple others).7 This confirmed previous size cutpoints and suggested further cutpoints in 1-cm increments. Non-size T descriptors were examined using multivariate Cox regression analysis that adjusted
Discussion
Definition of stage classification of lung cancer has undergone a transformative change with the engagement of the IASLC SPFC. The size of the database, the sophistication of the analysis, and the extent of internal and external validation are unprecedented among solid tumors. A debt is owed by the world to the many contributors who committed the time to provide the worldwide data that make this possible; nevertheless, there are surely aspects of the stage classification that can be improved. A
Conclusion
The eighth edition of TNM classification of lung cancer is the worldwide standard as of January 1, 2017. An extensive and multifaceted analysis served as the foundation for this revision. The T component is subdivided by primary tumor size in 1-cm increments as well as other descriptors of invasion into adjacent structures. The N component is determined by the location of involved lymph nodes. The M component is subdivided into intrathoracic dissemination, a single extrathoracic metastasis, and
Acknowledgments
Financial/nonfinancial disclosures: None declared.
Additional information: The e-Tables can be found in the Supplemental Materials section of the online article.
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