The IASLC Mesothelioma Staging Project: Proposals for the M Descriptors and for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Mesothelioma. Academic Article uri icon

Overview

abstract

  • INTRODUCTION: The M component and TNM stage groupings for malignant pleural mesothelioma (MPM) have been empirical. The International Association for the Study of Lung Cancer developed a multinational database to propose evidence-based revisions for the eighth edition of the TNM classification of MPM. METHODS: Data from 29 centers were submitted either electronically or by transfer of existing institutional databases. The M component as it currently stands was validated by confirming sufficient discrimination (by Kaplan-Meier analysis) with respect to overall survival (OS) between the clinical M0 (cM0) and cM1 categories. Candidate stage groups were developed by using a recursive partitioning and amalgamation algorithm applied to all cM0 cases. RESULTS: Of 3519 submitted cases, 2414 were analyzable and 84 were cM1 cases. Median OS for cM1 cases was 9.7 months versus 13.4 months (p = 0.0013) for the locally advanced (T4 or N3) cM0 cases, supporting inclusion of only cM1 in the stage IV group. Exploratory analyses suggest a possible difference in OS for single- versus multiple-site cM1 cases. A recursive partitioning and amalgamation-generated survival tree on the OS outcomes restricted to cM0 cases with the newly proposed (eighth edition) T and N components indicates that optimal stage groupings for the eighth edition will be as follows: stage IA (T1N0), stage IB (T2-3N0), stage II (T1-2N1), stage IIIA (T3N1), stage IIIB (T1-3N2 or any T4), and stage IV (any M1). CONCLUSIONS: This first evidence-based revision of the TNM classification for MPM leads to substantial changes in the T and N components and the stage groupings.

authors

  • Rusch, Valerie
  • Chansky, Kari
  • Kindler, Hedy L
  • Nowak, Anna K
  • Pass, Harvey I
  • Rice, David C
  • Shemanski, Lynn
  • Galateau-Sallé, Françoise
  • McCaughan, Brian C
  • Nakano, Takashi
  • Ruffini, Enrico
  • van Meerbeeck, Jan P
  • Yoshimura, Masahiro

publication date

  • September 28, 2016

Research

keywords

  • Lung Neoplasms
  • Mesothelioma
  • Neoplasm Staging
  • Pleural Neoplasms

Identity

Scopus Document Identifier

  • 85010754766

Digital Object Identifier (DOI)

  • 10.1016/j.jtho.2016.09.124

PubMed ID

  • 27687962

Additional Document Info

volume

  • 11

issue

  • 12