Display options
Cite
van Meerbeeck JP, Janssens A, Golden SH. The seventh tumour-node-metastasis staging system for lung cancer: Sequel or prequel?. EJC Suppl. 2013;11(2):150-8doi: 10.1016/j.ejcsup.2013.07.025.
van Meerbeeck, J. P., Janssens, A., & Golden, S. H. (2013). The seventh tumour-node-metastasis staging system for lung cancer: Sequel or prequel?. EJC supplements : EJC : official journal of EORTC, European Organization for Research and Treatment of Cancer ... [et al.], 11(2), 150-8. https://doi.org/10.1016/j.ejcsup.2013.07.025
van Meerbeeck, Jan P, et al. "The seventh tumour-node-metastasis staging system for lung cancer: Sequel or prequel?." EJC supplements : EJC : official journal of EORTC, European Organization for Research and Treatment of Cancer ... [et al.] vol. 11,2 (2013): 150-8. doi: https://doi.org/10.1016/j.ejcsup.2013.07.025
van Meerbeeck JP, Janssens A, Golden SH. The seventh tumour-node-metastasis staging system for lung cancer: Sequel or prequel?. EJC Suppl. 2013 Sep;11(2):150-8. doi: 10.1016/j.ejcsup.2013.07.025. PMID: 26217124; PMCID: PMC4041308.
Copy Download .nbib Format: NLM
Share it on

EJC Suppl. 2013 Sep;11(2):150-8. doi: 10.1016/j.ejcsup.2013.07.025.

The seventh tumour-node-metastasis staging system for lung cancer: Sequel or prequel?.

EJC supplements : EJC : official journal of EORTC, European Organization for Research and Treatment of Cancer ... [et al.]

Jan P van Meerbeeck, Annelies Janssens, Golden

Affiliations

  1. Oncology /MOCA, Antwerp University Hospital, Edegem, Belgium.

PMID: 26217124 PMCID: PMC4041308 DOI: 10.1016/j.ejcsup.2013.07.025

Abstract

Anatomical cancer extent is an important predictor of prognosis and determines treatment choices. In non-small-cell lung cancer (NSCLC) the tumour-node-metastasis (TNM) classification developed by Pierre Denoix replaced in 1968 the Veterans Administration Lung cancer Group (VALG) classification, which was still in use for small-cell lung cancer (SCLC). Clifton Mountain suggested several improvements based on a database of mostly surgically treated United States (US) patients from a limited number of centres. This database was pivotal for a uniform reporting of lung cancer extent by the American Joint Committee of Cancer (AJCC) and the International Union against Cancer (IUCC), but it suffered increasingly from obsolete diagnostic and staging procedures and did not reflect new treatment modalities. Moreover, its findings were not externally validated in large Japanese and European databases, resulting in persisting controversies which could not be solved with the available database. The use of different mediastinal lymph-node maps in Japan, the (US) and Europe facilitated neither the exchange nor the comparison of treatment results. Peter Goldstraw, a United Kingdom (UK) thoracic surgeon, started the process of updating the sixth version in 1996 and brought it to a good end 10 years later. His goals were to improve the TNM system in lung cancer by addressing the ongoing controversies, to validate the modifications and additional descriptors, to validate the TNM for use in staging SCLC and carcinoid tumours, to propose a new uniform lymph-node map and to investigate the prognostic value of non-anatomical factors. A staging committee was formed within the International Association for the Study of Lung Cancer (IASLC) - which supervised the collection of the retrospective data from >100,000 patients with lung cancer - treated throughout the world between 1990 and 2000, analyse them with the help of solid statistics and validate externally with the Surveillance, Epidemiology and End Results (SEER) database. The ten modifications and the mediastinal lymph-node map - which were proposed in 2007 and adopted by the AJCC and IUCC in their respective seventh revision of the TNM system - were implemented as of 2010 and were rapidly adopted by the thoracic oncology community and cancer registries. As expected, not all controversies could be fully addressed, and the need for a prospective data set containing more granular information was felt early on. This data set of 25,000 consecutive incident cases will form the base for the eighth revision in 2017 and is currently being collected. Other threats are the role of stage migration and the increasing number of biological factors interfering with disease extent for prognostication. The latter issue will be addressed by the creation of a prognostic index, including several prognostic factors, of which stage will be one. For the time being, the seventh TNM classification is considered the gold standard for the description of disease extent, initial treatment allocation and the reporting of treatment results. The uniform use of the TNM descriptors and the lymph-node map by all involved in lung cancer care is to be considered a process indicator of quality.

References

  1. J Thorac Cardiovasc Surg. 2010 Jun;139(6):1441-6 - PubMed
  2. J Thorac Oncol. 2009 May;4(5):652-7 - PubMed
  3. Am J Roentgenol Radium Ther Nucl Med. 1974 Jan;120(1):130-8 - PubMed
  4. J Thorac Cardiovasc Surg. 1975 Oct;70(4):606-12 - PubMed
  5. J Clin Oncol. 2008 Jul 20;26(21):3552-9 - PubMed
  6. J Thorac Oncol. 2007 Aug;2(8):706-14 - PubMed
  7. J Thorac Oncol. 2009 Sep;4(9):1049-59 - PubMed
  8. Ann Thorac Cardiovasc Surg. 2003 Dec;9(6):343-50 - PubMed
  9. J Thorac Oncol. 2007 Aug;2(8):682-3 - PubMed
  10. N Engl J Med. 1985 Jun 20;312(25):1604-8 - PubMed
  11. J Thorac Oncol. 2009 May;4(5):568-77 - PubMed
  12. Chest. 2009 Jul;136(1):6-8 - PubMed
  13. Chest. 2008 Mar;133(3):662-9 - PubMed
  14. J Thorac Oncol. 2012 Feb;7(2):390-6 - PubMed
  15. Thorax. 2006 Jul;61(7):597-603 - PubMed
  16. Lung Cancer. 2012 Nov;78(2):153-60 - PubMed
  17. J Thorac Oncol. 2007 Jul;2(7):593-602 - PubMed
  18. J Nucl Med. 2012 Jul;53(7):1007-15 - PubMed
  19. J Thorac Oncol. 2009 Jun;4(6):679-83 - PubMed
  20. Chest. 1986 Apr;89(4 Suppl):225S-233S - PubMed
  21. J Clin Oncol. 2008 Nov 1;26(31):5043-51 - PubMed
  22. Lung Cancer. 2005 Jul;49(1):25-33 - PubMed
  23. J Thorac Oncol. 2007 Dec;2(12):1067-77 - PubMed
  24. Ann Thorac Surg. 1995 Apr;59(4):863-6; discussion 867 - PubMed
  25. Cancer. 1999 Dec 15;86(12):2668-73 - PubMed
  26. Cancer Chemother Rep 3. 1973 Mar;4(2):31-42 - PubMed
  27. J Thorac Cardiovasc Surg. 1978 Dec;76(6):832-9 - PubMed
  28. J Thorac Oncol. 2007 Aug;2(8):686-93 - PubMed
  29. Chest. 1997 Jun;111(6):1710-7 - PubMed
  30. Eur Respir J. 2010 Aug;36(2):401-7 - PubMed
  31. Chest. 2009 Jul;136(1):260-71 - PubMed
  32. J Thorac Oncol. 2011 Jul;6(7):1229-35 - PubMed
  33. J Thorac Oncol. 2007 Jul;2(7):581-2 - PubMed
  34. Ann Oncol. 2012 Nov;23(11):2937-42 - PubMed
  35. J Thorac Oncol. 2008 Mar;3(3):216-27 - PubMed
  36. Arch Intern Med. 2008 Jul 28;168(14 ):1541-9 - PubMed
  37. J Thorac Oncol. 2008 Nov;3(11):1213-23 - PubMed
  38. Thorax. 1960 Mar;15:11-6 - PubMed
  39. J Clin Oncol. 2013 Mar 10;31(8):984-91 - PubMed
  40. Eur Radiol. 2007 Jan;17(1):23-32 - PubMed
  41. N Engl J Med. 2011 Aug 4;365(5):395-409 - PubMed
  42. J Thorac Oncol. 2012 Jun;7(6):963-72 - PubMed
  43. J Thorac Oncol. 2007 Aug;2(8):694-705 - PubMed
  44. J Thorac Oncol. 2008 Dec;3(12):1384-90 - PubMed
  45. J Thorac Oncol. 2011 Feb;6(2):244-85 - PubMed
  46. Chest. 2010 May;137(5):1172-80 - PubMed
  47. J Thorac Oncol. 2008 Feb;3(2):135-9 - PubMed
  48. Chest. 1997 Jun;111(6):1718-23 - PubMed
  49. J Clin Oncol. 2003 Mar 15;21(6):1029-34 - PubMed
  50. J Thorac Oncol. 2007 Jul;2(7):603-12 - PubMed
  51. J Thorac Oncol. 2009 Dec;4(12 ):1576-84 - PubMed
  52. Wien Med Wochenschr. 1951 Feb 3-10;101(5-6):102-3 - PubMed
  53. J Thorac Oncol. 2008 May;3(5):457-66 - PubMed

Publication Types