PMID- 30195703
OWN - NLM
STAT- MEDLINE
DCOM- 20191001
LR  - 20240420
IS  - 1556-1380 (Electronic)
IS  - 1556-0864 (Print)
IS  - 1556-0864 (Linking)
VI  - 13
IP  - 12
DP  - 2018 Dec
TI  - Implications of the Eighth Edition of the TNM Proposal: Invasive Versus Total 
      Tumor Size for the T Descriptor in Pathologic Stage I-IIA Lung Adenocarcinoma.
PG  - 1919-1929
LID - S1556-0864(18)33037-5 [pii]
LID - 10.1016/j.jtho.2018.08.2022 [doi]
AB  - INTRODUCTION: The eighth edition of the TNM staging system included the proposal 
      that the T descriptor be determined according to the invasive component, 
      excluding lepidic component, for nonmucinous lung adenocarcinomas. We sought to 
      conduct a clinicopathologic comparative analysis of the newly proposed 
      classification using invasive size versus total tumor size. METHODS: Patients who 
      underwent lung resection for primary lung adenocarcinoma with pathologic stage 
      (p-Stage) I-IIA (based on total size [t]) were reviewed (n = 1704). Pathologic 
      invasive size was measured, and tumors were reclassified using invasive size (i). 
      Cumulative incidence of recurrence and lung cancer-specific cumulative incidence 
      of death were analyzed using a competing-risks approach. Prognostic 
      discrimination by p-Stage(t) and p-Stage(i) was evaluated using a concordance 
      index (C-index). RESULTS: The use of invasive size resulted in downstaging in 377 
      of 1704 patients (22%), with twice as many patients with p-Stage IA1 (IA1[i] 
      versus IA1[t]: 389 [23%] versus 195 [11%]). However, outcomes were similar 
      between the two groups (IA1[i] versus IA1[t]: 5-year cumulative incidence of 
      recurrence, 11% versus 13%; 5-year lung cancer-specific cumulative incidence of 
      death, 5% versus 7%). Prognostic discrimination by p-Stage(i) was better than by 
      p-Stage(t) (C-index for p-Stage[i] versus p-Stage[t]: recurrence, 0.614 versus 
      0.593; lung cancer-specific death, 0.634 versus 0.621). CONCLUSIONS: When 
      invasive size, rather than total size, was used for the T descriptor, a larger 
      number of patients were classified with a favorable prognosis (p-Stage IA1) and 
      better prognostic discrimination of p-Stage I-IIA nonmucinous lung 
      adenocarcinomas was achieved.
CI  - Copyright (c) 2018 International Association for the Study of Lung Cancer. 
      Published by Elsevier Inc. All rights reserved.
FAU - Kameda, Koji
AU  - Kameda K
AD  - Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 
      New York, New York; Department of Thoracic Surgery, National Defense Medical 
      College, Tokorozawa, Japan.
FAU - Eguchi, Takashi
AU  - Eguchi T
AD  - Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 
      New York, New York; Division of Thoracic Surgery, Department of Surgery, Shinshu 
      University, Matsumoto, Japan.
FAU - Lu, Shaohua
AU  - Lu S
AD  - Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 
      New York, New York; Department of Pathology, Zhongshan Hospital, Fudan 
      University, Shanghai, China.
FAU - Qu, Yang
AU  - Qu Y
AD  - Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 
      New York, New York; Department of Pathology, Beijing Chest Hospital, Capital 
      Medical University, Beijing, China.
FAU - Tan, Kay See
AU  - Tan KS
AD  - Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer 
      Center, New York, New York.
FAU - Kadota, Kyuichi
AU  - Kadota K
AD  - Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 
      New York, New York; Department of Diagnostic Pathology, Faculty of Medicine, 
      Kagawa University, Kagawa, Japan.
FAU - Adusumilli, Prasad S
AU  - Adusumilli PS
AD  - Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 
      New York, New York; Center for Cell Engineering, Memorial Sloan Kettering Cancer 
      Center, New York, New York.
FAU - Travis, William D
AU  - Travis WD
AD  - Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New 
      York. Electronic address: travisw@mskcc.org.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
GR  - R01 CA236615/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20180907
PL  - United States
TA  - J Thorac Oncol
JT  - Journal of thoracic oncology : official publication of the International 
      Association for the Study of Lung Cancer
JID - 101274235
SB  - IM
MH  - Adenocarcinoma of Lung/*mortality/pathology/surgery
MH  - Aged
MH  - Carcinoma, Non-Small-Cell Lung/*mortality/pathology/surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lung Neoplasms/*mortality/pathology/surgery
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Invasiveness
MH  - Neoplasm Recurrence, Local/*mortality/pathology/surgery
MH  - Neoplasm Staging/*standards
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Tumor Burden
PMC - PMC6309787
MID - NIHMS1512039
OTO - NOTNLM
OT  - Consolidation tumor size
OT  - Invasive tumor size
OT  - Lung adenocarcinoma
OT  - Lung cancer-specific death
OT  - Recurrence
COIS- Disclosures of potential conflicts of interest: The authors have no potential 
      conflicts of interest.
EDAT- 2018/09/10 06:00
MHDA- 2019/10/02 06:00
PMCR- 2019/12/01
CRDT- 2018/09/10 06:00
PHST- 2018/06/28 00:00 [received]
PHST- 2018/08/14 00:00 [revised]
PHST- 2018/08/21 00:00 [accepted]
PHST- 2018/09/10 06:00 [pubmed]
PHST- 2019/10/02 06:00 [medline]
PHST- 2018/09/10 06:00 [entrez]
PHST- 2019/12/01 00:00 [pmc-release]
AID - S1556-0864(18)33037-5 [pii]
AID - 10.1016/j.jtho.2018.08.2022 [doi]
PST - ppublish
SO  - J Thorac Oncol. 2018 Dec;13(12):1919-1929. doi: 10.1016/j.jtho.2018.08.2022. Epub 
      2018 Sep 7.