J Korean Soc Radiol.  2014 Apr;70(4):261-268. 10.3348/jksr.2014.70.4.261.

Impact of the New International Association for the Study of Lung Cancer Staging System in Non-Small Cell Lung Cancer: With Comparison to the Union for International Cancer Control 6th Tumor, Node, Metastasis Edition

• Lee M
• Lee SW
• Shim SS
• Ryu YJ
• Kim Y

• KMID: 2041936
• DOI: http://doi.org/10.3348/jksr.2014.70.4.261

Abstract

PURPOSE
To investigate the impact of the proposed International Association for the Study of Lung Cancer (IASLC) tumor, node, metastasis (TNM) system on staging and outcome of non small cell lung cancer (NSCLC).
MATERIALS AND METHODS
With a total of 501 NSCLC patients with staging according to Union for International Cancer Control (UICC), 6th TNM (TNM-6) were reclassified according to the IASLC proposed TNM staging (TNM-7). The impact of TNM-7 in comparison with TNM-6 was evaluated at three levels: change in substage, staging, and outcome. The outcome measure was to compare the stage-specific overall survival of NSCLC between the two groups of patients.
RESULTS
A total of 214 (42.7%) patients had changed TNM staging, and 101 (20.2%) patients had changed stage groupings in TNM-7 compared to TNM-6. Among 100 patients showing changed stage grouping, 72 (14.4%) showed upstage and 29 (5.8%) demonstrated downstage. The TNM-7 system resulted in better separation of survival curves among stage-specific NSCLC than TNM-6 system, especially in separation of stage IIA vs. IIB (p = 0.023) and stage IIIB vs. IV (p < 0.001).
CONCLUSION
TNM-7 for lung cancer appears to be superior in defining stage-specific survival groups than TNM-6, especially between stage IIA vs. stage IIB and stage IIIB vs. stage IV.

MeSH Terms

Carcinoma, Non-Small-Cell Lung*
Humans
Lung Neoplasms*
Lung*
Neoplasm Metastasis*
Neoplasm Staging
Outcome Assessment (Health Care)
Small Cell Lung Carcinoma

Figure

• 

  Fig. 1 Overall survival of patients with non-small cell lung cancer by stage grouping for TNM-6 (A) and TNM-7 system (B). There were a significant differences in survival between stage IIA and IIB (p = 0.023) and IIIB and IV (p < 0.001), however, there was no significant difference between IIB and IIIA (p = 0.126). Note.-TNM = tumor, node, metastasis

• 

  Fig. 2 Overall Survival of patients with non-small cell lung cancer by T staging for TNM-6 (A) and TNM-7 system (B). There were a significant differences in survival between T1a and T1b (p = 0.010), T2a and T2b (p = 0.002), T2b and T3 (p < 0.001) in TNM-7 classification. Note.-TNM = tumor, node, metastasis

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