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Lung Cancer. 2014 Jul;85(1):7-11. doi: 10.1016/j.lungcan.2014.02.014. Epub 2014 Mar 3.

How many names for a rose: inconsistent classification of multiple foci of lung cancer due to ambiguous rules.

Author information

1
General Surgery Resident, Yale School of Medicine, PO Box 208062, New Haven, CT 06520-8062, United States.
2
Yale School of Medicine, Thoracic Surgery, PO Box 208062, New Haven, CT 06520-8062, United States. Electronic address: frank.detterbeck@yale.edu.

Abstract

OBJECTIVES:

Stage classification is important because it allows consistent definition of patient groups, and thus provides a foundation for comparison of outcomes. For patients with multiple pulmonary foci of lung cancer, however, the classification rules are ambiguous and confusing.

MATERIALS AND METHODS:

We surveyed experts and clinicians who regularly evaluate patients with lung cancer to see how similar or different their interpretation of the official stage classification was for such patients.

RESULTS:

We found a great deal of inconsistency in how four clinical scenarios were classified. No method of classification was chosen by a majority when there were more than two choices allowed by the classification rules. In a scenario with pulmonary foci of cancer of different histologic types, 86% classified this as separate primary cancers and 14% as multifocal lung cancer.

CONCLUSION:

The marked variability in classification must be taken into account when interpreting reported outcomes of patients with multiple pulmonary foci of lung cancer.

KEYWORDS:

Adenocarcinoma; Lung cancer; Multi foci; Non-small cell lung cancer; Stage classification; TNM

PMID:
24768582
DOI:
10.1016/j.lungcan.2014.02.014
[Indexed for MEDLINE]

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