Comparisons of the New TNM Staging System for Lung Cancer (UICC-7) and Revisions of the General Rules for the Clinical and Pathological Classification of Lung Cancer of the Japan Lung Cancer Society

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  • UICC第7版の主たる改訂点と"肺癌取扱い規約"における日本肺癌学会の対応

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Purpose. To clarify the details of revisions in the 7th TNM classification of lung cancer by the Union for International Cancer Control (UICC) and to describe the measures taken to adapt to these revisions by the General Rules for the Clinical and Pathological Classification Committee of the Japan Lung Cancer Society. Methods. We compared the 6th and 7th Editions of the UICC classification with the 7th Edition of the General Rules for the Clinical and Pathological Classification of Lung Cancer of the Japan Lung Cancer Society. Results. The main revisions of the 7th Edition of the TNM are as follows: 1) T-factors are now subclassified according to tumor diameter; 2) malignant effusion and pleural effusion are defined as M1a (formerly T4); an additional pulmonary nodule in the contralateral lung is now also defined as M1a; 3) pleural invasion (PL1) is now defined as T2; 4)T2bN0 and T2aN1 are defined as stage IIA (formerly IB and IIB, respectively); T4N0 and T4N1 are defined as stage IIIA (formerly IIIB); and 5) the lymph node map has been extensively revised. The General Rules for the Clinical and Pathological Classification Committee of the Japan Lung Cancer Society added several clarifications, revised its classification of surgical procedures and made new classifications for pathologists. Accordingly, the number of cases in each stage increased and the prognostic differentiation among stages has much improved. However, the TNM classification system has become more complex. Conclusion. It is necessary for the TNM classification system to reflect patient prognosis as accurately as possible. However, it remains to be clarified whether this staging system will require further amendment based on the emergence of new therapeutic methods such as epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors for EGFR-mutated lung cancer.<br>

Journal

  • Haigan

    Haigan 52 (1), 80-84, 2012

    The Japan Lung Cancer Society

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