The IASLC lung cancer staging project: Background data and proposed criteria to distinguish separate primary lung cancers from metastatic foci in patients with two lung tumors in the forthcoming eighth edition of the TNM classification for lung cancer

Frank C. Detterbeck, Wilbur A. Franklin, Andrew G. Nicholson, Nicolas Girard, Douglas A. Arenberg, William D. Travis, Peter J. Mazzone, Edith M. Marom, Jessica S. Donington, Lynn T. Tanoue, Valerie W. Rusch, Hisao Asamura, Ramón Rami-Porta

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Introduction: It can be difficult to distinguish between a second primary and a metastasis in patients with lung cancer who have more than one pulmonary site of cancer. Methods: A systematic review of the literature was conducted by a subcommittee of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee to develop recommendations to identify second primary lung cancers. The process entailed review of knowledge relating to the mechanism of metastasis, determination of clonality, and outcomes of patients with resected tumors. Results: It is easier to determine that two tumors are different than that they are the same; finding similarities does not establish that they are the same. For example, most second primary lung cancers are of the same histotype. Few criteria are reliable by themselves; these include different histologic cancer types or matching DNA breakpoints by sequencing and a comprehensive histologic assessment of resected specimens. Characteristics that are suggestive but associated with potential misclassification include the presence or absence of biomarkers, imaging characteristics, and the presence or absence of nodal involvement. Conclusions: Clinical and pathologic (i.e., after resection) criteria are presented to identify two foci as separate primary lung cancers versus a metastasis. Few features are definitive; many commonly used characteristics are suggestive but associated with a substantial rate of misclassi-fication. Careful review by a multidisciplinary tumor board, considering all available information, is recommended.

Original languageEnglish
Pages (from-to)651-665
Number of pages15
JournalJournal of Thoracic Oncology
Volume11
Issue number5
DOIs
Publication statusPublished - 2016

Fingerprint

Neoplasm Staging
Lung Neoplasms
Lung
Second Primary Neoplasms
Neoplasms
Neoplasm Metastasis
DNA Sequence Analysis
Biomarkers

Keywords

  • Lung cancer
  • Lung cancer staging
  • Multiple tumors
  • Non-small cell lung cancer
  • TNM classification

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

The IASLC lung cancer staging project : Background data and proposed criteria to distinguish separate primary lung cancers from metastatic foci in patients with two lung tumors in the forthcoming eighth edition of the TNM classification for lung cancer. / Detterbeck, Frank C.; Franklin, Wilbur A.; Nicholson, Andrew G.; Girard, Nicolas; Arenberg, Douglas A.; Travis, William D.; Mazzone, Peter J.; Marom, Edith M.; Donington, Jessica S.; Tanoue, Lynn T.; Rusch, Valerie W.; Asamura, Hisao; Rami-Porta, Ramón.

In: Journal of Thoracic Oncology, Vol. 11, No. 5, 2016, p. 651-665.

Research output: Contribution to journalArticle

Detterbeck, Frank C. ; Franklin, Wilbur A. ; Nicholson, Andrew G. ; Girard, Nicolas ; Arenberg, Douglas A. ; Travis, William D. ; Mazzone, Peter J. ; Marom, Edith M. ; Donington, Jessica S. ; Tanoue, Lynn T. ; Rusch, Valerie W. ; Asamura, Hisao ; Rami-Porta, Ramón. / The IASLC lung cancer staging project : Background data and proposed criteria to distinguish separate primary lung cancers from metastatic foci in patients with two lung tumors in the forthcoming eighth edition of the TNM classification for lung cancer. In: Journal of Thoracic Oncology. 2016 ; Vol. 11, No. 5. pp. 651-665.
@article{dba9bf6e1c764268afcf48b66826cb51,
title = "The IASLC lung cancer staging project: Background data and proposed criteria to distinguish separate primary lung cancers from metastatic foci in patients with two lung tumors in the forthcoming eighth edition of the TNM classification for lung cancer",
abstract = "Introduction: It can be difficult to distinguish between a second primary and a metastasis in patients with lung cancer who have more than one pulmonary site of cancer. Methods: A systematic review of the literature was conducted by a subcommittee of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee to develop recommendations to identify second primary lung cancers. The process entailed review of knowledge relating to the mechanism of metastasis, determination of clonality, and outcomes of patients with resected tumors. Results: It is easier to determine that two tumors are different than that they are the same; finding similarities does not establish that they are the same. For example, most second primary lung cancers are of the same histotype. Few criteria are reliable by themselves; these include different histologic cancer types or matching DNA breakpoints by sequencing and a comprehensive histologic assessment of resected specimens. Characteristics that are suggestive but associated with potential misclassification include the presence or absence of biomarkers, imaging characteristics, and the presence or absence of nodal involvement. Conclusions: Clinical and pathologic (i.e., after resection) criteria are presented to identify two foci as separate primary lung cancers versus a metastasis. Few features are definitive; many commonly used characteristics are suggestive but associated with a substantial rate of misclassi-fication. Careful review by a multidisciplinary tumor board, considering all available information, is recommended.",
keywords = "Lung cancer, Lung cancer staging, Multiple tumors, Non-small cell lung cancer, TNM classification",
author = "Detterbeck, {Frank C.} and Franklin, {Wilbur A.} and Nicholson, {Andrew G.} and Nicolas Girard and Arenberg, {Douglas A.} and Travis, {William D.} and Mazzone, {Peter J.} and Marom, {Edith M.} and Donington, {Jessica S.} and Tanoue, {Lynn T.} and Rusch, {Valerie W.} and Hisao Asamura and Ram{\'o}n Rami-Porta",
year = "2016",
doi = "10.1016/j.jtho.2016.01.025",
language = "English",
volume = "11",
pages = "651--665",
journal = "Journal of Thoracic Oncology",
issn = "1556-0864",
publisher = "International Association for the Study of Lung Cancer",
number = "5",

}

TY - JOUR

T1 - The IASLC lung cancer staging project

T2 - Background data and proposed criteria to distinguish separate primary lung cancers from metastatic foci in patients with two lung tumors in the forthcoming eighth edition of the TNM classification for lung cancer

AU - Detterbeck, Frank C.

AU - Franklin, Wilbur A.

AU - Nicholson, Andrew G.

AU - Girard, Nicolas

AU - Arenberg, Douglas A.

AU - Travis, William D.

AU - Mazzone, Peter J.

AU - Marom, Edith M.

AU - Donington, Jessica S.

AU - Tanoue, Lynn T.

AU - Rusch, Valerie W.

AU - Asamura, Hisao

AU - Rami-Porta, Ramón

PY - 2016

Y1 - 2016

N2 - Introduction: It can be difficult to distinguish between a second primary and a metastasis in patients with lung cancer who have more than one pulmonary site of cancer. Methods: A systematic review of the literature was conducted by a subcommittee of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee to develop recommendations to identify second primary lung cancers. The process entailed review of knowledge relating to the mechanism of metastasis, determination of clonality, and outcomes of patients with resected tumors. Results: It is easier to determine that two tumors are different than that they are the same; finding similarities does not establish that they are the same. For example, most second primary lung cancers are of the same histotype. Few criteria are reliable by themselves; these include different histologic cancer types or matching DNA breakpoints by sequencing and a comprehensive histologic assessment of resected specimens. Characteristics that are suggestive but associated with potential misclassification include the presence or absence of biomarkers, imaging characteristics, and the presence or absence of nodal involvement. Conclusions: Clinical and pathologic (i.e., after resection) criteria are presented to identify two foci as separate primary lung cancers versus a metastasis. Few features are definitive; many commonly used characteristics are suggestive but associated with a substantial rate of misclassi-fication. Careful review by a multidisciplinary tumor board, considering all available information, is recommended.

AB - Introduction: It can be difficult to distinguish between a second primary and a metastasis in patients with lung cancer who have more than one pulmonary site of cancer. Methods: A systematic review of the literature was conducted by a subcommittee of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee to develop recommendations to identify second primary lung cancers. The process entailed review of knowledge relating to the mechanism of metastasis, determination of clonality, and outcomes of patients with resected tumors. Results: It is easier to determine that two tumors are different than that they are the same; finding similarities does not establish that they are the same. For example, most second primary lung cancers are of the same histotype. Few criteria are reliable by themselves; these include different histologic cancer types or matching DNA breakpoints by sequencing and a comprehensive histologic assessment of resected specimens. Characteristics that are suggestive but associated with potential misclassification include the presence or absence of biomarkers, imaging characteristics, and the presence or absence of nodal involvement. Conclusions: Clinical and pathologic (i.e., after resection) criteria are presented to identify two foci as separate primary lung cancers versus a metastasis. Few features are definitive; many commonly used characteristics are suggestive but associated with a substantial rate of misclassi-fication. Careful review by a multidisciplinary tumor board, considering all available information, is recommended.

KW - Lung cancer

KW - Lung cancer staging

KW - Multiple tumors

KW - Non-small cell lung cancer

KW - TNM classification

UR - http://www.scopus.com/inward/record.url?scp=84969903612&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84969903612&partnerID=8YFLogxK

U2 - 10.1016/j.jtho.2016.01.025

DO - 10.1016/j.jtho.2016.01.025

M3 - Article

C2 - 26944304

AN - SCOPUS:84969903612

VL - 11

SP - 651

EP - 665

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

SN - 1556-0864

IS - 5

ER -