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

IASLC Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions

Research output: Contribution to journalArticle

64 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1109-1121
Number of pages13
JournalJournal of Thoracic Oncology
Volume12
Issue number7
DOIs
StatePublished - Jul 1 2017

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Neoplasm Staging
Lung Neoplasms
Databases
Neoplasms
Information Storage and Retrieval
Cohort Studies
Multivariate Analysis

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

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. / IASLC Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions.

In: Journal of Thoracic Oncology, Vol. 12, No. 7, 01.07.2017, p. 1109-1121.

Research output: Contribution to journalArticle

IASLC Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions. / 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. In: Journal of Thoracic Oncology. 2017 ; Vol. 12, No. 7. pp. 1109-1121.
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title = "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",
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",
author = "{IASLC Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions} and Kari Chansky and Detterbeck, {Frank C.} and Nicholson, {Andrew G.} and Rusch, {Valerie W.} and Eric Valli{\`e}res and Patti Groome and Catherine Kennedy and Mark Krasnik and Michael Peake and Lynn Shemanski and Vanessa Bolejack and Crowley, {John J.} and Hisao Asamura and Ram{\'o}n Rami-Porta and Peter Goldstraw and Ram{\'o}n Rami-Porta and Hisao Asamura and David Ball and Beer, {David G.} and Ricardo Beyruti and Vanessa Bolejack and Kari Chansky and John Crowley and Frank Detterbeck and {Erich Eberhardt}, {Wilfried Ernst} and John Edwards and Fran{\cc}oise Galateau-Sall{\'e} and Dorothy Giroux and Fergus Gleeson and Patti Groome and James Huang and Catherine Kennedy and Jhingook Kim and Kim, {Young Tae} and Laura Kingsbury and Haruhiko Kondo and Mark Krasnik and Kaoru Kubota and Antoon Lerut and Gustavo Lyons and Mirella Marino and Marom, {Edith M.} and {van Meerbeeck}, Jan and Alan Mitchell and Takashi Nakano and Nicholson, {Andrew G.} and Anna Nowak and Michael Peake and Thomas Rice and Kemp Kernstine",
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T2 - External Validation of the Revision of the TNM Stage Groupings in the Eighth Edition of the TNM Classification of Lung Cancer

AU - IASLC Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions

AU - Chansky, Kari

AU - Detterbeck, Frank C.

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AU - Rusch, Valerie W.

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AU - Groome, Patti

AU - Kennedy, Catherine

AU - Krasnik, Mark

AU - Peake, Michael

AU - Shemanski, Lynn

AU - Bolejack, Vanessa

AU - Crowley, John J.

AU - Asamura, Hisao

AU - Rami-Porta, Ramón

AU - Goldstraw, Peter

AU - Rami-Porta, Ramón

AU - Asamura, Hisao

AU - Ball, David

AU - Beer, David G.

AU - Beyruti, Ricardo

AU - Bolejack, Vanessa

AU - Chansky, Kari

AU - Crowley, John

AU - Detterbeck, Frank

AU - Erich Eberhardt, Wilfried Ernst

AU - Edwards, John

AU - Galateau-Sallé, Françoise

AU - Giroux, Dorothy

AU - Gleeson, Fergus

AU - Groome, Patti

AU - Huang, James

AU - Kennedy, Catherine

AU - Kim, Jhingook

AU - Kim, Young Tae

AU - Kingsbury, Laura

AU - Kondo, Haruhiko

AU - Krasnik, Mark

AU - Kubota, Kaoru

AU - Lerut, Antoon

AU - Lyons, Gustavo

AU - Marino, Mirella

AU - Marom, Edith M.

AU - van Meerbeeck, Jan

AU - Mitchell, Alan

AU - Nakano, Takashi

AU - Nicholson, Andrew G.

AU - Nowak, Anna

AU - Peake, Michael

AU - Rice, Thomas

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N2 - 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.

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KW - AJCC

KW - Lung cancer

KW - National Cancer Database

KW - Staging

KW - UICC

KW - Validation

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