The IASLC Lung Cancer Staging Project: Background Data and Proposals for the Application of TNM Staging Rules to Lung Cancer Presenting as Multiple Nodules with Ground Glass or Lepidic Features or a Pneumonic Type of Involvement in the Forthcoming Eighth Edition of the TNM Classification

被引：185

作者：

Detterbeck, Frank C. ^{[1
]}

Marom, Edith M. ^{[2
]}

Arenberg, Douglas A. ^{[3
]}

Franklin, Wilbur A. ^{[4
]}

Nicholson, Andrew G. ^{[5
,6
]}

Travis, William D. ^{[7
]}

Girard, Nicolas ^{[8
]}

Mazzone, Peter J. ^{[9
]}

Donington, Jessica S. ^{[10
]}

Tanoue, Lynn T. ^{[11
]}

Rusch, Valerie W. ^{[12
]}

Asamura, Hisao ^{[13
]}

Rami-Porta, Ramon ^{[14
,15
]}

机构：

[1] Yale Univ, Dept Surg, New Haven, CT USA

[2] Tel Aviv Univ, Dept Diagnost Imaging, Ramat Gan, Israel

[3] Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA

[4] Univ Colorado, Dept Pathol, Denver, CO 80202 USA

[5] Royal Brompton & Harefield Natl Hlth Serv Fdn Tru, Dept Histopathol, London, England

[6] Univ London Imperial Coll Sci Technol & Med, London, England

[7] Mem Sloan Kettering Canc Ctr, Dept Pathol, 1275 York Ave, New York, NY 10021 USA

[8] Hosp Civils Lyon, Resp Med Serv, Hop Louis Pradel, Lyon, France

[9] Cleveland Clin, Dept Internal Med, Cleveland, OH 44106 USA

[10] NYU, Dept Thorac Surg, New York, NY USA

[11] Yale Univ, Dept Internal Med, New Haven, CT USA

[12] Mem Sloan Kettering Canc Ctr, Thorac Surg Serv, 1275 York Ave, New York, NY 10021 USA

[13] Keio Univ, Sch Med, Div Thorac Surg, Tokyo, Japan

[14] Hosp Univ Mutua Terrassa, Thorac Surg Serv, Barcelona, Spain

[15] Ctr Invest Biomed Red Enfermedades Resp CIBERES, Lung Canc Grp, Barcelona, Spain

来源：

JOURNAL OF THORACIC ONCOLOGY | 2016年 / 11卷 / 05期

基金：

美国国家卫生研究院;

关键词：

Lung cancer; Non-small cell lung cancer; TNM classification; Lung cancer staging; Multiple tumors; HIGH-RESOLUTION CT; BRONCHIOLOALVEOLAR CELL-CARCINOMA; ATYPICAL ADENOMATOUS HYPERPLASIA; SUBSOLID PULMONARY NODULES; THIN-SECTION CT; SURGICAL-TREATMENT; OPACITY NODULES; BRONCHOALVEOLAR CARCINOMA; CLINICAL-SIGNIFICANCE; PERIPHERAL ADENOCARCINOMA;

D O I：

10.1016/j.jtho.2015.12.113

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

Introduction: Application of tumor, node, and metastasis (TNM) classification is difficult in patients with lung cancer presenting as multiple ground glass nodules or with diffuse pneumonic-type involvement. Clarification of how to do this is needed for the forthcoming eighth edition of TNM classification. Methods: A subcommittee of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee conducted a systematic literature review to build an evidence base regarding such tumors. An iterative process that included an extended workgroup was used to develop proposals for TNM classification. Results: Patients with multiple tumors with a prominent ground glass component on imaging or lepidic component on microscopy are being seen with increasing frequency. These tumors are associated with good survival after resection and a decreased propensity for nodal and extra thoracic metastases. Diffuse pneumonic-type involvement in the lung is associated with a worse prognosis, but also with a decreased propensity for nodal and distant metastases. Conclusion: For multifocal ground glass/lepidic tumors, we propose that the T category be determined by the highest T lesion, with either the number of tumors or m in parentheses to denote the multifocal nature, and that a single N and M category be used for all the lesions collectively for example, T1a(3)NOMO or T1b(m)NOMO. For diffuse pneumonic-type lung cancer we propose that the T category be designated by size (or T3) if in one lobe, as T4 if involving an ipsilateral different lobe, or as M1a if contralateral and that a single N and M category be used for all pulmonary areas of involvement. (C) 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

引用

页码：666 / 680

页数：15

共 91 条

[1]

Outcomes for Lung Transplantation for Lung Cancer in the United Network for Organ Sharing Registry [J].