Updated Staging System for Lung Cancer

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The TNM classification has traditionally applied to all carcinomas of the lung, including SCLC. However, the TNM classification has only been applied to those unusually localized cases of SCLC suitable for surgical treatment, oncologists preferring the simpler, binary division into limited disease and extensive disease. The IASLC Staging Committee, having formulated its recommendations for the seventh edition of TNM from an analysis of the 68,463 cases of NSCLC, studied the usefulness of the

Proposals for testing

The TNM classification allows for proposals for new classification to be trialed for a period to assess whether they should be incorporated into future editions. The IASLC Staging Project developed several such proposals. It is hoped that clinicians, radiologists, and pathologists will collect data on these features to allow future analysis, such as:

  • 1.

    Imaging evidence of lymphangitis carcinomatosis is usually a contraindication to surgical treatment. The L category, which is used to assess

Summary

The anatomic extent of disease, as reflected by the TNM classification, has stood the test of time and remains an important prognostic factor in most tumor sites. In lung cancer, it is still the most important prognostic factor in most clinical scenarios. The changes developed for the seventh edition have aligned stage with prognosis more accurately than had ever been possible previously. The challenge for the future is to combine TNM with other prognostic factors to develop a composite

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Financial disclosure: The author has nothing to disclose.

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