Faculty Information |
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Article types | Original article |
Language | English |
Refereed paper | Refereed |
Title | The IASLC Mesothelioma Staging Project: Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma. |
Journal | Formal name:Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer Abbreviation:J Thorac Oncol ISSN code:1556-1380(Electronic)1556-0864(Linking) |
Domestic / Foregin | Foregin |
Volume, Number, Page | 11(12),pp.2100-2111 |
Papers・Author | Rice David, Chansky Kari, Nowak Anna, Pass Harvey, Kindler Hedy, Shemanski Lynn, Opitz Isabelle, Call Sergi, Hasegawa Seiki, Kernstine Kemp, Atinkaya Cansel, Rea Federico, Nafteux Philippe, Rusch Valerie W. |
Publication date | 2016/12 |
Papers・Description | INTRODUCTION:Nodal categories for malignant pleural mesothelioma are derived from the lung cancer staging system and have not been adequately validated. The International Association for the Study of Lung Cancer developed a multinational database to generate evidence-based recommendations to inform the eighth edition of the TNM classification of malignant pleural mesothelioma.METHODS:Data from 29 centers were entered prospectively (n = 1566) or by transfer of retrospective data (n = 1953). Survival according to the seventh edition N categories was evaluated using Kaplan-Meier survival curves and Cox proportional hazards regression analysis. Survival was measured from the date of diagnosis.RESULTS:There were 2432 analyzable cases: 1603 had clinical (c) staging, 1614 had pathologic (p) staging, and 785 had both. For clinically staged tumors there was no separation in Kaplan-Meier curves between cN0, cN1 or cN2 (cN1 versus cN0 hazard ratio [HR] = 1.06, p = 0.77 and cN2 versus cN1 HR = 1.04, p = 0.85). For pathologically staged tumors, patients with pN1 or pN2 tumors had worse survival than those with pN0 tumors (HR = 1.51, p < 0.0001) but no survival difference was noted between those with pN1 and pN2 tumors (HR = 0.99, p = 0.99). Patients with both pN1 and pN2 nodal involvement had poorer survival than those with pN2 tumors only (HR = 1.60, p = 0.007) or pN0 tumors (HR = 1.62, p<0.0001).CONCLUSIONS:A recommendation to collapse both clinical and pN1 and pN2 categories into a single N category comprising ipsilateral, intrathoracic nodal metastases (N1) will be made for the eighth edition staging system. Nodes previously categorized as N3 will be reclassified as N2. |
DOI | 10.1016/j.jtho.2016.09.121 |
PMID | 27687964 |