Virtual Library

Start Your Search

J. Mayer



Author of

  • +

    MA10 - Facing the Real World: New Staging System and Response Evaluation in Immunotherapy (ID 393)

    • Event: WCLC 2016
    • Type: Mini Oral Session
    • Track: Radiology/Staging/Screening
    • Presentations: 1
    • +

      MA10.02 - Clinical Staging in the 8th Edition TNM for Lung Cancer is Inaccurate (ID 6362)

      14:26 - 14:32  |  Author(s): J. Mayer

      • Abstract
      • Presentation
      • Slides

      Background:
      The new classification for lung cancer refines the T-descriptor criteria into more categories. We examined whether this affects the accuracy of clinical staging, and how this affects the final stage of patients.

      Methods:
      71 patients underwent resection for primary lung cancer from January 2014 to December 2014. T-component was measured based on the maximum tumour size on CT, PET-CT and histology report. The possible effect on staging based on T-component was compared between both TNMs.

      Results:
      PET-CT more accurately estimates the pathological size of the tumor (mean difference from histology: CT 3mm (range -1.6 to 2.6cm) and PET-CT 1.3mm (-2 to 2.5cm). Discordance between radiological and pathological T-stage was higher with the 8th edition (7th edition concordance CT 42(59%) and PET-CT 31(43%), 8th edition CT 31(44%) and PET-CT 29(41%) (CT p=0.01; PET-CT p=0.7)). The final stage groupings was also more discrepant in the 8th edition. Concordance was for CT 7th Edition 37(54%) vs 8th Edition 21(31%) (p<0.001), and for PET-CT 34(48%) vs 19(28%) (p<0.001). The discrepancy in stage grouping is contributed significantly by T-stage discordance. In the 30 patients who were not upstaged pathologically by pleural invasion or nodal staging, there is a over 50% increase in inaccuracy of clinical staging in the 8th edition. The CT concordance was 7th edition 24(80%), 8th edition 13(43%) (p<0.001); and for PET-CT 23(77%) vs 10(33%) (p<0.001).

      Conclusion:
      We showed that the 8th edition TNM lung cancer staging system was associated with a significant increase in discordance between clinical and pathological staging due to differences in measurement of tumour size and consequently T-stage groupings by different modalities. This has implications for prognostication and clinical trial interpretation especially in patients who do not undergo surgery for pathological stage confirmation.Figure 1



      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.