New aspects in the staging of lung cancer. Prospective validation of the international union against cancer TNM classification

Abstract

Background and Methods. To validate the new TNM definitions for lung cancer (International Union Against Cancer [UICC]) TNM classification, 4th edition, 1987, the data of 3823 patients were analyzed prospec‐tively in terms of concordance between clinical (TNM) and pathologically confirmed classification (pTNM), the value of the various diagnostic techniques in estimating the pathologically confirmed classification, and the prognostic relevance of the new TNM definitions. Results. With regard to the primary tumor (T), clinical and pathologic classifications were identical in 63%; with regard to lymph node involvement (N), the agreement was 47%; for distant metastasis agreement occurred in 91% of cases and for the stages it occurred in 56%. As to the primary tumor (T), the accuracy of radiography (59%) was nearly identical to that of computed tomography (CT) (58%). Both techniques were less precise in determining the extent of lymph node involvement (CT, correct assessments in 50%; radiography, correct assessments in 43%). The statistically significant differences in the prognosis for the T, N, and M categories and for the stages and the categories of the new R classification could be confirmed. Allowance should be made for the different prognosis between TlNOMO and T2NOMO by the new Substages IA and Ib of Stage I. Conclusions. By the new TNM definitions for bronchus carcinoma, international conformity became feasible and practical, and the improvement of its prognostic relevance provided a more reliable basis for establishing guidelines for individual oncologic concepts. Cancer 1992; 70:1102–1110.

Multiple molecular marker testing (p53, C-Ki-ras, c-erbB-2) improves estimation of prognosis in potentially curative resected non-small cell lung cancer

“…Our treatment results for curatively (UICC RO) resected NSCLC based on various parameters (UICC tumour stage, pT-category, pN-category, grading of the primary tumour and histological subtype) as shown in Table 1 are in good agreement with the large reference series in the literature (Buelzebruck et al, 1992;Mountain, 1986;Naruke et al, 1988). The major problem in comparing studies of p185 expression in NSCLC is the enormous variation in frequencies of NSCLC tumours scored positive for p185.…”

“…From 136 patients consecutively operated for the clinical diagnosis of lung cancer, 103 patients fulfilled the following inclusion criteria and were prospectively evaluated: (I) NSCLC histology of Multiple molecular marker testing (p53, C-Ki-ras, c-erbB-2) improves estimation of prognosis in potentially curative resected non-small cell lung cancer the following WHO subtypes (World Health Organization, 1982): squamous cell carcinoma (SCC), adenocarcinoma (AC) or large cell carcinoma (LC); (II) complete tumour resection (RO category; Hermanek et al, 1993) by at least a lobectomy as minimal extent of resection; (III) systematic lymphadenectomy as quality control (Buelzebruck et al, 1992;Holmes, 1994); (IV): histopathological UICC stage I, II or IIIA; (V): postoperative radiotherapy for histopathological stage IIIA; (VI) no prior history of a malignant tumour or radiation and/or chemotherapy before sampling of the tissue specimes to be analysed; (VII) no perioperative 30-days lethality.…”

“…The World Health Organization histologic classification of lung cancer (World Health Organization, 1982) describes 3 major subtypes of non-small cell lung cancer (NSCLC), squamous cell carcinoma (SCC), adenocarcinoma (AC) and large cell carcinoma (LC) which represent approximately 75% of all lung cancer cases. Radical surgery (RO resection) offers the only chance for cure in patients with NSCLC and survival probabilities are mainly dependent on tumour stage (Mountain, 1986;Buelzebruck et al, 1992).…”

Prognostic Implications Of Calbindin-D28k Expression in Lung Cancer: Analysis of 452 Cases

“…The histologic classification of each tumor was based on the World Health Organization criteria (10). Stage was determined using the TNM system (11).…”

Bevacizumab in the treatment of non-small-cell lung cancer

“…An estimated 174 000 new diagnoses and 162 000 deaths are expected from lung cancer in the United States in 2006 (Jemal et al, 2006). Approximately 85% of patients will have the non-small-cell histology, and approximately 55% of patients will present with locally advanced or metastatic disease (Bulzebruck et al, 1992;Govindan et al, 2006). The current standard treatment for patients with preserved functional status is double-agent cytotoxic chemotherapy (Pfister et al, 2004).…”