The IASLC lung cancer staging project

Proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer

International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee and Advisory Board Members

Research output: Contribution to journalReview article

158 Citations (Scopus)

Abstract

This article proposes codes for the primary tumor categories of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) and a uniform way to measure tumor size in part-solid tumors for the eighth edition of the tumor, node, and metastasis classification of lung cancer. In 2011, new entities of AIS, MIA, and lepidic predominant adenocarcinoma were defined, and they were later incorporated into the 2015 World Health Organization classification of lung cancer. To fit these entities into the T component of the staging system, the Tis category is proposed for AIS, with Tis (AIS) specified if it is to be distinguished from squamous cell carcinoma in situ (SCIS), which is to be designated Tis (SCIS). We also propose that MIA be classified as T1mi. Furthermore, the use of the invasive size for T descriptor size follows a recommendation made in three editions of the Union for International Cancer Control tumor, node, and metastasis supplement since 2003. For tumor size, the greatest dimension should be reported both clinically and pathologically. In nonmucinous lung adenocarcinomas, the computed tomography (CT) findings of ground glass versus solid opacities tend to correspond respectively to lepidic versus invasive patterns seen pathologically. However, this correlation is not absolute; so when CT features suggest nonmucinous AIS, MIA, and lepidic predominant adenocarcinoma, the suspected diagnosis and clinical staging should be regarded as a preliminary assessment that is subject to revision after pathologic evaluation of resected specimens. The ability to predict invasive versus noninvasive size on the basis of solid versus ground glass components is not applicable to mucinous AIS, MIA, or invasive mucinous adenocarcinomas because they generally show solid nodules or consolidation on CT.

Original languageEnglish
Pages (from-to)1204-1223
Number of pages20
JournalJournal of Thoracic Oncology
Volume11
Issue number8
DOIs
Publication statusPublished - 2016

Fingerprint

Neoplasm Staging
Lung Neoplasms
Adenocarcinoma
Neoplasms
Mucinous Adenocarcinoma
Carcinoma in Situ
Tomography
Glass
Squamous Cell Carcinoma
Neoplasm Metastasis
Adenocarcinoma in Situ

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

The IASLC lung cancer staging project : Proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer. / International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee and Advisory Board Members.

In: Journal of Thoracic Oncology, Vol. 11, No. 8, 2016, p. 1204-1223.

Research output: Contribution to journalReview article

International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee and Advisory Board Members. / The IASLC lung cancer staging project : Proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer. In: Journal of Thoracic Oncology. 2016 ; Vol. 11, No. 8. pp. 1204-1223.
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title = "The IASLC lung cancer staging project: Proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer",
abstract = "This article proposes codes for the primary tumor categories of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) and a uniform way to measure tumor size in part-solid tumors for the eighth edition of the tumor, node, and metastasis classification of lung cancer. In 2011, new entities of AIS, MIA, and lepidic predominant adenocarcinoma were defined, and they were later incorporated into the 2015 World Health Organization classification of lung cancer. To fit these entities into the T component of the staging system, the Tis category is proposed for AIS, with Tis (AIS) specified if it is to be distinguished from squamous cell carcinoma in situ (SCIS), which is to be designated Tis (SCIS). We also propose that MIA be classified as T1mi. Furthermore, the use of the invasive size for T descriptor size follows a recommendation made in three editions of the Union for International Cancer Control tumor, node, and metastasis supplement since 2003. For tumor size, the greatest dimension should be reported both clinically and pathologically. In nonmucinous lung adenocarcinomas, the computed tomography (CT) findings of ground glass versus solid opacities tend to correspond respectively to lepidic versus invasive patterns seen pathologically. However, this correlation is not absolute; so when CT features suggest nonmucinous AIS, MIA, and lepidic predominant adenocarcinoma, the suspected diagnosis and clinical staging should be regarded as a preliminary assessment that is subject to revision after pathologic evaluation of resected specimens. The ability to predict invasive versus noninvasive size on the basis of solid versus ground glass components is not applicable to mucinous AIS, MIA, or invasive mucinous adenocarcinomas because they generally show solid nodules or consolidation on CT.",
author = "{International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee and Advisory Board Members} and Travis, {William D.} and Hisao Asamura and Bankier, {Alexander A.} and Beasley, {Mary Beth} and Frank Detterbeck and Flieder, {Douglas B.} and Goo, {Jin Mo} and Heber MacMahon and David Naidich and Nicholson, {Andrew G.} and Powell, {Charles A.} and Mathias Prokop and Ram{\'o}n Rami-Porta and Valerie Rusch and {Van Schil}, Paul and Yasushi Yatabe and Peter Goldstraw and David Ball and David Beer and Ricardo Beyruti and Vanessa Bolejack and Kari Chansky and John Crowley and Eberhardt, {Wilfried Ernst Erich} and John Edwards and Fran{\cc}oise Galateau-Sall{\'e} and Dorothy Giroux and Fergus Gleeson and Patti Groome and James Huang and Catherine Kennedy and Jhingook Kim and Kim, {Young Tae} and Laura Kingsbury and Haruhiko Kondo and Mark Krasnik and Kaoru Kubota and Antoon Lerut and Gustavo Lyons and Mirella Marino and Marom, {Edith M.} and {Van Meerbeeck}, Jan and Alan Mitchell and Takashi Nakano and Anna Nowak and Michael Peake and Thomas Rice and Kenneth Rosenzweig and Enrico Ruffini and Nagahiro Saijo",
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AU - International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee and Advisory Board Members

AU - Travis, William D.

AU - Asamura, Hisao

AU - Bankier, Alexander A.

AU - Beasley, Mary Beth

AU - Detterbeck, Frank

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AU - Crowley, John

AU - Eberhardt, Wilfried Ernst Erich

AU - Edwards, John

AU - Galateau-Sallé, Françoise

AU - Giroux, Dorothy

AU - Gleeson, Fergus

AU - Groome, Patti

AU - Huang, James

AU - Kennedy, Catherine

AU - Kim, Jhingook

AU - Kim, Young Tae

AU - Kingsbury, Laura

AU - Kondo, Haruhiko

AU - Krasnik, Mark

AU - Kubota, Kaoru

AU - Lerut, Antoon

AU - Lyons, Gustavo

AU - Marino, Mirella

AU - Marom, Edith M.

AU - Van Meerbeeck, Jan

AU - Mitchell, Alan

AU - Nakano, Takashi

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PY - 2016

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N2 - This article proposes codes for the primary tumor categories of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) and a uniform way to measure tumor size in part-solid tumors for the eighth edition of the tumor, node, and metastasis classification of lung cancer. In 2011, new entities of AIS, MIA, and lepidic predominant adenocarcinoma were defined, and they were later incorporated into the 2015 World Health Organization classification of lung cancer. To fit these entities into the T component of the staging system, the Tis category is proposed for AIS, with Tis (AIS) specified if it is to be distinguished from squamous cell carcinoma in situ (SCIS), which is to be designated Tis (SCIS). We also propose that MIA be classified as T1mi. Furthermore, the use of the invasive size for T descriptor size follows a recommendation made in three editions of the Union for International Cancer Control tumor, node, and metastasis supplement since 2003. For tumor size, the greatest dimension should be reported both clinically and pathologically. In nonmucinous lung adenocarcinomas, the computed tomography (CT) findings of ground glass versus solid opacities tend to correspond respectively to lepidic versus invasive patterns seen pathologically. However, this correlation is not absolute; so when CT features suggest nonmucinous AIS, MIA, and lepidic predominant adenocarcinoma, the suspected diagnosis and clinical staging should be regarded as a preliminary assessment that is subject to revision after pathologic evaluation of resected specimens. The ability to predict invasive versus noninvasive size on the basis of solid versus ground glass components is not applicable to mucinous AIS, MIA, or invasive mucinous adenocarcinomas because they generally show solid nodules or consolidation on CT.

AB - This article proposes codes for the primary tumor categories of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) and a uniform way to measure tumor size in part-solid tumors for the eighth edition of the tumor, node, and metastasis classification of lung cancer. In 2011, new entities of AIS, MIA, and lepidic predominant adenocarcinoma were defined, and they were later incorporated into the 2015 World Health Organization classification of lung cancer. To fit these entities into the T component of the staging system, the Tis category is proposed for AIS, with Tis (AIS) specified if it is to be distinguished from squamous cell carcinoma in situ (SCIS), which is to be designated Tis (SCIS). We also propose that MIA be classified as T1mi. Furthermore, the use of the invasive size for T descriptor size follows a recommendation made in three editions of the Union for International Cancer Control tumor, node, and metastasis supplement since 2003. For tumor size, the greatest dimension should be reported both clinically and pathologically. In nonmucinous lung adenocarcinomas, the computed tomography (CT) findings of ground glass versus solid opacities tend to correspond respectively to lepidic versus invasive patterns seen pathologically. However, this correlation is not absolute; so when CT features suggest nonmucinous AIS, MIA, and lepidic predominant adenocarcinoma, the suspected diagnosis and clinical staging should be regarded as a preliminary assessment that is subject to revision after pathologic evaluation of resected specimens. The ability to predict invasive versus noninvasive size on the basis of solid versus ground glass components is not applicable to mucinous AIS, MIA, or invasive mucinous adenocarcinomas because they generally show solid nodules or consolidation on CT.

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