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

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