The IASLC Lung Cancer Staging Project: Proposals for the Revision of the N Descriptors in the Forthcoming Seventh Edition of the TNM Classification for Lung Cancer

Rusch, Valerie W.; Crowley, John; Giroux, Dorothy J.; Goldstraw, Peter; Im, Jung-Gi; Tsuboi, Masahiro; Tsuchiya, Ryosuke; Vansteenkiste, Johan

doi:10.1097/jto.0b013e31807ec803

Cited by 474 publications

(369 citation statements)

References 40 publications

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“…[1,5] Therefore, the examination of lymph nodes is critical step. [6,7] The incidence of pathological N2 disease following surgical resection and systematic mediastinal lymph node dissection varies between 17.6 and 26.5%.…”

Section: Discussionmentioning

confidence: 99%

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Skip metastasis in non-small cell lung cancer: does it affect the prognosis?

Akçay¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada küçük hücreli dışı akciğer kanseri nedeni ile rezeksiyon yapılan hastalarda skip metastazları incelendi. Çalışma planı: Kliniğimizde Ocak 2005 -Aralık 2011 tarihleri arasında küçük hücreli dışı akciğer kanseri tanısı konan ve R0 akciğer rezeksiyonu örneklerinin patolojik incelemesi sonucunda aynı taraf mediastinal lenf nodu metastazı saptanan toplam 111 hasta (94 erkek, 17 kadın; ort. yaş: 58.9±10.2 yıl; dağılım 35-82 yıl) retrospektif olarak incelendi. Hastalar skip metastazlı grup (sN2) (grup 1, n=55) [N1(-), N2(+)] ve skip metastazı olmayan aynı taraf mediastinal lenf nodu metastazlı grup (nsN2) (grup 2, n=56) [N1(+), N2(+)] olmak üzere iki gruba ayrıldı. Bul gu lar: Her iki çalışma grubunda medyan sağkalım 25 ay olup, beş yıllık genel sağkalım oranı %13 idi. Beş yıllık genel sağkalım oranı grup 2'ye kıyasla grup 1'de daha yüksek olmakla birlikte (sırasıyla %7.4'e karşın %20), fark istatistiksel olarak anlamlı değildi (p=0.084). Sonuç: Çalışma sonuçlarımız istatistiksel olarak anlamlı bir fark olmasa da skip metastazı olmayan hastalara kıyasla, skip metastazlı ameliyat edilebilir hastalarda beş yıllık genel sağkalım oranının daha yüksek olduğunu göstermektedir.Anahtar sözcükler: Mediastinal lenf nodu; küçük hücreli dışı akciğer kanseri; skip metastazı. ABSTRACTBackground: This study aims to examine skip metastases in patients who had resection due to non-small cell lung cancer. Methods: A total of 111 patients (94 males, 17 females; mean age: 58.9±10.2 years; range 35 to 82 years) who were diagnosed with non-small cell lung cancer and in whom an ipsilateral mediastinal lymph node metastasis was detected based on the pathological examination of the R0 pulmonary resection samples between January 2005 and December 2011 in our clinic were retrospectively analyzed. The patients were divided into two groups: the skip metastasis group (sN2) (group 1, n=55) [N1(-), N2(+)] and non-skip ipsilateral mediastinal lymph node metastasis group (nsN2) (group 2, n=56) [N1(+), N2(+)]. Results: The median survival was 25 months and fiveyear overall survival rate was 13% for both study groups. Five-year overall survival rate was higher in group 1, compared to group 2 (20% vs. 7.4%, respectively), although the difference was not statistically significant (p=0.084). Conclusion: Our study results show that five-year overall survival rates of operable patients with skip metastases are higher than those without skip metastases, although the difference is not statistically significant.

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Section: Discussionmentioning

confidence: 99%

“…[1] The accepted model for the lymphatic drainage in non-small cell lung cancer (NSCLC) is the spread from the tumor to the intraparenchymal lymph nodes and, then, to the hilar lymph nodes. The next station is the ipsilateral mediastinal lymph nodes.…”

mentioning

confidence: 99%

Skip metastasis in non-small cell lung cancer: does it affect the prognosis?

Akçay¹

2017

Turk Gogus Kalp Dama

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“…Survival in this subgroup of patients approached 30% at 5-years in some historical series [10]. It is now recognised that patients with single station N2 node have a similar survival to those with multiple N1 disease [17]. RIQUET et al [92] have also reported that patients with skip mediastinal lymphadenopathy (N2) have a better survival than those with N1 plus N2 disease.…”

Section: N2 Diseasementioning

confidence: 95%

“…The importance of hilar and mediastinal lymph node involvement has long been recognised as an important prognostic factor in lung cancer [17]. The actual classification of lymph nodes combines the features of the first proposed classification (Naruke), advocated by the American Joint Committee on Cancer Staging, and of the second classification: the nodal map proposed by the American Thoracic Society.…”

Section: Clinical and Surgical Stagingmentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

European Respiratory Review

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Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

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“…35 The lymph node status should be reported as the number of lymph nodes involved and the total number of lymph nodes submitted, specifying the site(s) of involvement (lymph node stations) according to the IASLC lymph node map. 11 Given the nature of the procedure, lymph nodes obtained by mediastinoscopy are often received fragmented and unless specified by the surgeon, it may not be possible to distinguish a single fragmented lymph node from fragments of multiple lymph nodes.…”

Section: Microscopic Elementsmentioning

confidence: 99%

Data Set for Reporting of Lung Carcinomas: Recommendations From International Collaboration on Cancer Reporting

Jones

Churg²,

Henderson³

et al. 2013

Archives of Pathology & Laboratory Medicine

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Objective.-To develop an evidence-based reporting data set for each cancer site.Design.-A project to develop data sets for prostate, endometrium, and lung cancers and malignant melanoma was piloted by the quadripartite group.Results.-A set of required and recommended data elements and appropriate responses for each element were agreed upon for the reporting of lung cancer.Conclusions.-This review describes the process of development of the lung cancer data set.

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The IASLC Lung Cancer Staging Project: Proposals for the Revision of the N Descriptors in the Forthcoming Seventh Edition of the TNM Classification for Lung Cancer

Abstract: Current N descriptors should be maintained in the NSCLC staging system. Prospective studies are needed to validate amalgamating lymph node stations into zones and subdividing N descriptors.

Cited by 474 publications

References 40 publications

Skip metastasis in non-small cell lung cancer: does it affect the prognosis?

Skip metastasis in non-small cell lung cancer: does it affect the prognosis?

Surgery for nonsmall cell lung cancer

Data Set for Reporting of Lung Carcinomas: Recommendations From International Collaboration on Cancer Reporting

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