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

Research output: Contribution to journalArticle

99 Scopus citations

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 2017

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

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    IASLC Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions, & IASLC Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions (2017). 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. Journal of Thoracic Oncology, 12(7), 1109-1121. https://doi.org/10.1016/j.jtho.2017.04.011