WCLC 2016: New Lung Cancer Tumor Staging Manual to Shape Clinical Treatment
A revised tumor classification based on more than 70,000 non–small cell lung cancer patients and 6,100 small cell lung cancer patients is now available to lung cancer specialists around the world in the form of the 8th edition of the tumor, node, and metastasis (TNM) classification. The new edition is published by the Union for International Cancer Control, the American Joint Committee on Cancer, and the International Association for the Study of Lung Cancer (IASLC) in their respective staging manuals.
According to Ramon Rami-Porta, MD, of the Hospital Universitari Mutua Terrrassa, in Terrassa, Spain, the new edition seeks to improve the classification of anatomical extent of lung cancer. He presented his overview of the 8th edition at the IASLC World Conference on Lung Cancer in Vienna, Austria.
In 1998, IASLC established its Lung Cancer Staging Project, which led to the development of an international lung cancer database. Once established, IASLC can create updates to stay current with evolving research and new clinical practice and guidelines.
Innovation in the 8th edition of TNM classification of lung cancer is based on the analyses of the new IASLC database that includes 70,967 evaluable patients with non–small cell lung cancer and 6,189 with small cell lung cancer.
“These innovations will lead to some changes in clinical practice that are worth reflecting on,” said Dr. Rami-Porta. “For example, tumor size is a much more relevant prognostic factor than in previous editions and is now a descriptor in all T categories. Tumor size measurement should be carefully performed because small changes in size mean important changes in prognosis.”
“Still, other categories may not see any significant changes between the publication of the 7th and 8th editions,” Dr. Rami-Porta added. “The 8th edition will help us refine prognosis both at clinical and pathologic staging and stratify tumors in future clinical trials, but will require more attention from us at measuring tumor size, at determining nodal disease, at searching for metastases, and at using clinical judgment to indicate treatment.”
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