IASLC Staging Articles
The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Overview of Challenges and Opportunities in Revising the Nodal Classification of Lung Cancer
The status of lymph node involvement is a major component of the TNM staging system. The N categories for lung cancer have remained unchanged since the fourth edition of the TNM staging system, partly because of differences in nodal mapping nomenclature, partly because of insufficient details to verify possible alternative approaches for staging. In preparation for the rigorous analysis of the International Association for the Study of Lung Cancer database necessary for the ninth edition TNM staging system, members of the N-Descriptors Subcommittee of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee reviewed the evidence for alternative approaches to categorizing the extent of lymph node involvement with lung cancer, which is currently based solely on the anatomical location of lymph node metastasis.The International Association for the Study of Lung Cancer Thymic Epithelial Tumor Staging Project: Unresolved Issues to be Addressed for the Next Ninth Edition of the TNM Classification of Malignant Tumors
Thymic epithelial tumors are presently staged using a consistent TNM classification developed by the International Association for the Study of Lung Cancer (IASLC) and approved by the Union for International Cancer Control and the American Joint Committee on Cancer. The stage classification is incorporated in the eight edition of the TNM classification of thoracic malignancies. The IASLC Staging and Prognostic Factors Committee (SPFC)—Thymic Domain (TD) is in charge for the next (ninth) edition expected in 2024.The International Association for the Study of Lung Cancer Staging Project: Methods and Guiding Principles for the Development of the Ninth Edition TNM Classification
Stage classification provides a consistent and concise nomenclature about the anatomic extent of the cancer. This is a fundamental cornerstone in the management of patients; it enables reporting results and facilitates comparing one treatment to another and judging how closely clinical trial results apply to an individual patient. A nomenclature must be relatively static; however, periodical refinement is needed to adjust to a changing landscape of clinical relevance. Changes must be well justified and thoughtfully developed to maintain the ability to communicate clearly and facilitate comparisons across time.The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer
The IASLC Staging and Prognostic Factors Committee has collected a new database of 94,708 cases donated from 35 sources in 16 countries around the globe. This has now been analysed by our statistical partners at Cancer Research And Biostatistics and, in close collaboration with the members of the committee proposals have been developed for the T, N, and M categories of the 8th edition of the TNM Classification for lung cancer due to be published late 2016. In this publication we describe the methods used to evaluate the resultant Stage groupings and the proposals put forward for the 8th edition.Effect of Tumor Size on Prognosis in Patients Treated with Radical Radiotherapy or Chemoradiotherapy for Non–Small Cell Lung Cancer: An Analysis of the Staging Project Database of the International Association for the Study of Lung Cancer
Analysis of the International Association for the Study of Lung Cancer database revealed that for patients with completely resected, node-negative, non–small-cell lung cancer (NSCLC), increasing tumor size was associated with worsening survival. This analysis was performed to determine the effect of size on prognosis in patients in the same database but who were treated with radiotherapy or chemoradiotherapy.Carcinoma In Situ at the Bronchial Resection Margin: A Review
Carcinoma in situ at the mucosal bronchial resection margin is a rarely reported event. At present, such histological findings at the resection margins are classified as R1(is), thus representing an incomplete resection. A review of the English literature on the topic was undertaken to try to better define the significance of such findings and to define possible areas of prospective data acquisition to further define the problem and its management.Recommendations for Uniform Definitions of Surgical Techniques for Malignant Pleural Mesothelioma: A Consensus Report of the International Association for the Study of Lung Cancer International Staging Committee and the International Mesothelioma Interest Group
Extrapleural pneumonectomy has been well defined; however, surgeons vary regarding the surgical extent and goals of “pleurectomy/decortication” (P/D). We explored mesothelioma surgeons' concepts of P/D with the aim of unifying surgical nomenclature.The IASLC Lung Cancer Staging Project: A Proposal for a New International Lymph Node Map in the Forthcoming Seventh Edition of the TNM Classification for Lung Cancer
The accurate assessment of lymph node involvement is an important part of the management of lung cancer. Lymph node “maps” have been used to describe the location of nodal metastases. However, discrepancies in nomenclature among maps used by Asian and Western countries hinder analyses of lung cancer treatment outcome. To achieve uniformity and to promote future analyses of a planned prospective international database, the International Association for the Study of Lung Cancer proposes a new lymph node map which reconciles differences among currently used maps, and provides precise anatomic definitions for all lymph node stations.Visceral Pleural Invasion: Pathologic Criteria and Use of Elastic Stains: Proposal for the 7th Edition of the TNM Classification for Lung Cancer
To define the anatomic extent of visceral pleural invasion (VPI) and to assess whether elastic stains are useful to determine VPI in lung cancer. The elastic layer of the visceral pleura is not mentioned in the current International Union Against Cancer or American Joint Committee on Cancer staging documents.The IASLC Lung Cancer Staging Project: Proposals for the Inclusion of Broncho-Pulmonary Carcinoid Tumors in the Forthcoming (Seventh) Edition of the TNM Classification for Lung Cancer
In the 2003 Supplement for tumor, node, metastasis (TNM) Staging classification it states that TNM staging “applies to all types of carcinoma including small cell carcinoma; however, it does not apply to carcinoids.” Despite this caveat, most publications on typical and atypical carcinoids use the TNM staging system for nonsmall cell carcinoma and are able to demonstrate prognostic significance for the different stages. For this reason, as the next TNM Staging proposal is being considered, we sought to investigate the carcinoid cases submitted to the International Association for the Study of Lung Cancer (IASLC) database, as well as the National Cancer Institute Surveillance Epidemiology and End Results (SEER).The IASLC Lung Cancer Staging Project: Proposals for the Revision of the TNM Stage Groupings in the Forthcoming (Seventh) Edition of the TNM Classification of Malignant Tumours
The seventh edition of the TNM Classification of Malignant Tumors is due to be published early in 2009. In preparation for this, the International Association for the Study of Lung Cancer established its Lung Cancer Staging Project in 1998. The recommendations of this committee for changes to the T, N, and M descriptors have been published. This report contains the proposals for the new stage groupings.
