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J Thorac Oncol. 2017 Jul;12(7):1109-1121. doi: 10.1016/j.jtho.2017.04.011. Epub 2017 Apr 28.

The IASLC Lung Cancer Staging Project: External Validation of the Revision of the TNM Stage Groupings in the Eighth Edition of the TNM Classification of Lung Cancer.

Collaborators (142)

Goldstraw P, Rami-Porta R, Asamura H, Ball D, Beer DG, Beyruti R, Bolejack V, Chansky K, Crowley J, Detterbeck F, Erich Eberhardt WE, Edwards J, Galateau-Sallé F, Giroux D, Gleeson F, Groome P, Huang J, Kennedy C, Kim J, Kim YT, Kingsbury L, Kondo H, Krasnik M, Kubota K, Lerut A, Lyons G, Marino M, Marom EM, van Meerbeeck J, Mitchell A, Nakano T, Nicholson AG, Nowak A, Peake M, Rice T, Rosenzweig K, Ruffini E, Rusch V, Saijo N, Van Schil P, Sculier JP, Shemanski L, Stratton K, Suzuki K, Tachimori Y, Thomas CF Jr, Travis W, Tsao MS, Turrisi A, Vansteenkiste J, Watanabe H, Wu YL, Baas P, Erasmus J, Hasegawa S, Inai K, Kernstine K, Kindler H, Krug L, Nackaerts K, Pass H, Rice D, Falkson C, Filosso PL, Giaccone G, Kondo K, Lucchi M, Okumura M, Blackstone E, Cavaco FA, Barrera EA, Arca JA, Lamelas IP, Obrer AA, Jorge RG, Ball D, Bascom GK, Orozco AIB, Castro MAG, Blum MG, Chimondeguy D, Cvijanovic V, Defranchi S, de Olaiz Navarro B, Campuzano IE, Vidueira IM, Araujo EF, García FA, Fong KM, Corral GF, González SC, Gilart JF, Arangüena LG, Barajas SG, Girard P, Goksel T, Budiño MTG, Casaurrán GG, Blanco JAG, Hernández JH, Rodríguez HH, Collantes JH, Heras MI, Elena JMI, Jakobsen E, Kostas S, Atance PL, Ares AN, Liao M, Losanovscky M, Lyons G, Magaroles R, De Esteban Júlvez L, Gorospe MM, McCaughan B, Kennedy C, Íñiguez RM, Sorribes LM, Gozalo SN, Álvarez de Arriba C, Delgado MN, Alarcón JP, Cuesta JCP, Park JS, Pass H, Fernández MJP, Rosenberg M, Ruffini E, Rusch V, Sánchez de Cos Escuín J, Vinuesa AS, Mitjans MS, Strand TE, Subotic D, Swisher S, Terra R, Thomas C, Tournoy K, Van Schil P, Velasquez M, Wu YL, Yokoi K.

Author information

1
Cancer Research And Biostatistics, Seattle, Washington. Electronic address: karic@crab.org.
2
Department of Surgery, Yale University, New Haven, Connecticut.
3
Department of Histopathology, Royal Brompton and Harefield National Health Service Foundation Trust and Imperial College, London, United Kingdom.
4
Thoracic Surgery Service, Sloan-Kettering Cancer Center, New York, New York.
5
Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington.
6
Queen's Cancer Research Institute, Kingston, Ontario, Canada.
7
University of Sydney, Sydney, Australia.
8
Gentofte University Hospital, Copenhagen, Denmark.
9
University of Leicester, Glenfield Hospital, Leicester, United Kingdom.
10
Cancer Research And Biostatistics, Seattle, Washington.
11
Division of Thoracic Surgery, Keio School of Medicine, Tokyo, Japan.
12
Thoracic Surgery Service, Hospital Universitari Mutua Terrassa, University of Barcelona; Centros de Investigación Biomédica en Red de Enfermedades Respiratorias CIBERES Lung Cancer Group, Terrassa, Barcelona, Spain.

Abstract

INTRODUCTION:

Revisions to the TNM stage classifications for lung cancer, informed by the international database (N = 94,708) of the International Association for the Study of Lung Cancer (IASLC) Staging and Prognostic Factors Committee, need external validation. The objective was to externally validate the revisions by using the National Cancer Data Base (NCDB) of the American College of Surgeons.

METHODS:

Cases presenting from 2000 through 2012 were drawn from the NCDB and reclassified according to the eighth edition stage classification. Clinically and pathologically staged subsets of NSCLC were analyzed separately. The T, N, and overall TNM classifications were evaluated according to clinical, pathologic, and "best" stage (N = 780,294). Multivariate analyses were carried out to adjust for various confounding factors. A combined analysis of the NSCLC cases from both databases was performed to explore differences in overall survival prognosis between the two databases.

RESULTS:

The databases differed in terms of key factors related to data source. Survival was greater in the IASLC database for all stage categories. However, the eighth edition TNM stage classification system demonstrated consistent ability to discriminate TNM categories and stage groups for clinical and pathologic stage.

CONCLUSIONS:

The IASLC revisions made for the eighth edition of lung cancer staging are validated by this analysis of the NCDB database by the ordering, statistical differences, and homogeneity within stage groups and by the consistency within analyses of specific cohorts.

KEYWORDS:

AJCC; Lung cancer; National Cancer Database; Staging; UICC; Validation

PMID:
28461257
DOI:
10.1016/j.jtho.2017.04.011
[Indexed for MEDLINE]
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