TY - JOUR
T1 - The International Association for the Study of Lung Cancer Staging Project for Lung Cancer
T2 - Proposals for the Revision of the N Descriptors in the Forthcoming Ninth Edition of the TNM Classification for Lung Cancer
AU - Members of the Staging and Prognostic Factors Committee, Members of the Advisory Boards, and Participating Institutions of the Lung Cancer Domain
AU - Huang, James
AU - Osarogiagbon, Raymond U.
AU - Giroux, Dorothy J.
AU - Nishimura, Katherine K.
AU - Bille, Andrea
AU - Cardillo, Giuseppe
AU - Detterbeck, Frank
AU - Kernstine, Kemp
AU - Kim, Hong Kwan
AU - Lievens, Yolande
AU - Lim, Eric
AU - Marom, Edith
AU - Prosch, Helmut
AU - Putora, Paul Martin
AU - Rami-Porta, Ramon
AU - Rice, David
AU - Rocco, Gaetano
AU - Rusch, Valerie W.
AU - Opitz, Isabelle
AU - Vasquez, Francisco Suarez
AU - Van Schil, Paul
AU - Jeffrey Yang, Chi Fu
AU - Asamura, Hisao
N1 - Publisher Copyright:
© 2023 International Association for the Study of Lung Cancer
PY - 2024
Y1 - 2024
N2 - Introduction: The accurate assessment of nodal (N) status is crucial to the management and prognostication of nonmetastatic NSCLC. We sought to determine whether the current N descriptors should be maintained or revised for the upcoming ninth edition of the international TNM lung cancer staging system. Methods: Data were assembled by the International Association for the Study of Lung Cancer on patients with NSCLC, detailing both clinical and pathologic N status, with information about anatomical location and individual station-level identification. Survival was calculated by the Kaplan-Meier method and prognostic groups were assessed by a Cox regression analysis. Results: Data for clinical N and pathologic N status were available in 45,032 and 35,009 patients, respectively. The current N0 to N3 descriptors for both clinical N and pathologic N categories reflect prognostically distinct groups. Furthermore, single-station N2 involvement (N2a) exhibited a better prognosis than multistation N2 involvement (N2b) in both clinical and pathologic classifications, and the differences between all neighboring nodal subcategories were highly significant. The prognostic differences between N2a and N2b were robust and consistent across resection status, histologic type, T category, and geographic region. Conclusions: The current N descriptors should be maintained, with the addition of new subdescriptors to N2 for single-station involvement (N2a) and multiple-station involvement (N2b).
AB - Introduction: The accurate assessment of nodal (N) status is crucial to the management and prognostication of nonmetastatic NSCLC. We sought to determine whether the current N descriptors should be maintained or revised for the upcoming ninth edition of the international TNM lung cancer staging system. Methods: Data were assembled by the International Association for the Study of Lung Cancer on patients with NSCLC, detailing both clinical and pathologic N status, with information about anatomical location and individual station-level identification. Survival was calculated by the Kaplan-Meier method and prognostic groups were assessed by a Cox regression analysis. Results: Data for clinical N and pathologic N status were available in 45,032 and 35,009 patients, respectively. The current N0 to N3 descriptors for both clinical N and pathologic N categories reflect prognostically distinct groups. Furthermore, single-station N2 involvement (N2a) exhibited a better prognosis than multistation N2 involvement (N2b) in both clinical and pathologic classifications, and the differences between all neighboring nodal subcategories were highly significant. The prognostic differences between N2a and N2b were robust and consistent across resection status, histologic type, T category, and geographic region. Conclusions: The current N descriptors should be maintained, with the addition of new subdescriptors to N2 for single-station involvement (N2a) and multiple-station involvement (N2b).
KW - Lung cancer
KW - Lung cancer staging
KW - Lymph node metastasis
KW - N component
KW - N descriptors
KW - TNM classification
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U2 - 10.1016/j.jtho.2023.10.012
DO - 10.1016/j.jtho.2023.10.012
M3 - Article
C2 - 37866624
AN - SCOPUS:85181843481
SN - 1556-0864
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
ER -