ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2007
The IASLC Lung Cancer Staging Project: proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 165 papers, 5 of them syntheses that pooled it.
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Who cites it
165 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Wedge Resection vs. Stereotactic Body Radiation Therapy for Clinical Stage I Non-small Cell Lung Cancer: A Systematic Review and Meta-Analysis.Frontiers in surgery · 2022Pooled it
- Characteristics and prognosis of synchronous multiple primary lung cancer after surgical treatment: A systematic review and meta-analysis of current evidence.Cancer medicine · 2021Pooled it
- Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2018Guideline
- Extent of Visceral Pleural Invasion Affects Prognosis of Resected Non-small Cell Lung Cancer: A meta-analysis.Scientific reports · 2017Pooled it
- Lung cancer screening.Journal of the National Comprehensive Cancer Network : JNCCN · 2012Guideline
- Prognostic factors and survival prediction of resected non-small cell lung cancer with ipsilateral pulmonary metastases: a study based on the Surveillance, Epidemiology, and End Results (SEER) database.BMC pulmonary medicine · 2023Trial
- Radiofrequency ablation of stage IA non-small cell lung cancer in patients ineligible for surgery: results of a prospective multicenter phase II trial.Journal of cardiothoracic surgery · 2018Trial
- A randomized phase II study of radiation induced immune boost in operable non-small cell lung cancer (RadImmune trial).BMC cancer · 2015Trial
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- Clinical outcome and predictors of survival and pneumonitis after stereotactic ablative radiotherapy for stage I non-small cell lung cancer.Radiation oncology (London, England) · 2012Trial
- A pooled exploratory analysis of the effect of tumor size and KRAS mutations on survival benefit from adjuvant platinum-based chemotherapy in node-negative non-small cell lung cancer.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2012Trial
- Recommendations for implementing stereotactic radiotherapy in peripheral stage IA non-small cell lung cancer: report from the Quality Assurance Working Party of the randomised phase III ROSEL study.Radiation oncology (London, England) · 2009Trial
- Adjuvant paclitaxel plus carboplatin compared with observation in stage IB non-small-cell lung cancer: CALGB 9633 with the Cancer and Leukemia Group B, Radiation Therapy Oncology Group, and North Central Cancer Treatment Group Study Groups.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2008Trial
- Impact of tumor size by clinical N subclassification and histology in trimodality-treated N2 non-small cell lung cancer.Scientific reports · 2025Article
- Pleural invasion of peripheral cT1 lung cancer by deep learning analysis of thoracoscopic images: a retrospective pilot study.Journal of thoracic disease · 2025Article
- Non-small cell lung cancer in ever-smokers vs never-smokers.BMC medicine · 2025Article
- The TNM classification of lung cancer-a historic perspective.Journal of thoracic disease · 2024Review
- Safety and local efficacy of computed tomography-guided microwave ablation for treating early-stage non-small cell lung cancer adjacent to bronchovascular bundles.European radiology · 2024Article
- Subsecond lung cancer detection within a heterogeneous background of normal and benign tissue using single-point Raman spectroscopy.Journal of biomedical optics · 2023Article
- Investigation of the non-small cell lung cancer patients with bronchus involvements: A population-based study.The clinical respiratory journal · 2023Article
105 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo propose changes in the seventh revision of the tumor, node, metastasis (TNM) classification for lung cancer.
methodsData on 100,869 patients were submitted to the international database, and data for 18,198 of these patients fulfilled the inclusion criteria for the T component analysis. Survival was calculated for clinical and pathologic T1, T2, T3, T4NOMO completely resected (R0), and for each T descriptor. A running log-rank test was used to assess cutpoints by tumor size. Results were internally and externally validated.
resultsOn the basis of the optimal cutpoints, pT1NOR0 was divided into pT1a < or =2 cm (n = 1816) and pT1b >2 to 3 cm (n = 1653) with 5-year survival rates of 77 and 71% (p < 0.0001). The pT2NOR0 cutpoints resulted in pT2a >3 to 5 cm (n = 2822), pT2b >5 to 7 cm (n = 825), and pT2c >7 cm (n = 364). Their 5-year survival rates were 58, 49, and 35% (p < 0.0001). For clinically staged N0, 5-year survival was 53% for cT1a, 47% for cT1b, 43% for cT2a, 36% for cT2b, and 26% for cT2c. pT3NO (n = 711) and pT4 (any N) (n = 340) had 5-year survival rates of 38 and 22%. pT4 (additional nodule(s) in the same lobe) (n = 363) had a 5-year survival rate of 28%, similar to pT3 (p = 0.28) and better than other pT4 (p = 0.0029). For pM1 (ipsilateral pulmonary nodules) (n = 180), 5-year survival was 22%, similar to pT4. For cT4-malignant pleural effusion/nodules, 5-year survival was 2%.
conclusionRecommended changes in the T classification are to subclassify T1 into T1a and T1b, and T2 into T2a and T2b; and to reclassify T2c and additional nodule(s) in the same lobe as T3, nodule(s) in the ipsilateral nonprimary lobe as T4, and malignant pleural or pericardial effusions as M1.
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