ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2024
The International Association for the Study of Lung Cancer Mesothelioma Staging Project: Proposals for the "N" Descriptors in the Forthcoming Ninth Edition of the TNM Classification for Pleural Mesothelioma.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Radiologist's Guide to the Ninth Edition TNM Staging System for Quantitative and Qualitative Assessment of Pleural Mesothelioma.Radiology · 2025Guideline
- The 9th Edition of the UICC TNM Classification of Malignant Tumours: Updates and Rationale for Change.International journal of cancer · 2026Review
- A single-center experience in parenchyma-sparing surgical treatment of malignant pleural mesothelioma.Updates in surgery · 2026Article
- Pleural Mesothelioma: Current Therapeutic Strategies and Future Directions.Current oncology reports · 2026Review
- Review
- A Diagnostic Approach to Malignant Pleural Mesothelioma.Pulmonary therapy · 2025Article
- Pleural mesothelioma.Nature reviews. Disease primers · 2025Review
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Authors and funding
12 authors.
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Abstract
introductionThe International Association for the Study of Lung Cancer developed an international database to inform potential revisions in the ninth edition of the TNM classification of diffuse pleural mesothelioma (PM). This study analyzed the clinical and pathologic N categories to determine whether revisions were indicated relative to the eighth edition staging system.
methodsOf 7338 PM cases diagnosed from 2013 to 2022 and 3598 met all inclusion criteria for planned analyses. Data on 2836 patients without metastases were included in this study. Overall survival (OS) was measured from date of diagnosis. Patients were included regardless of whether they received neoadjuvant treatment. For the pathologic N analysis, patients who underwent resection (extrapleural pneumonectomy or pleurectomy/decortication) were included. N subgroups were analyzed and OS assessed by the Kaplan-Meier method.
resultsThe existing eighth edition N categories were performed adequately in the ninth edition data set. A median OS advantage was noted for clinical and pathologic N0 versus N1 patients: 23.2 versus 18.5 and 33.8 versus 25.0 months, respectively. Patients with resected pN0 had a 3-year OS of 48%. No difference in OS was noted for single- versus multiple-station nodal metastases. The number of nodal stations sampled at the time of resection was not associated with a difference in OS.
conclusionsData regarding clinical and pathologic N categories corroborate those used in the eighth edition. No changes in the N categories are recommended in the ninth edition of PM staging system.
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