Non-small cell lung cancer staging: proposed revisions to the TNM system

Patients with non-small cell lung cancer (NSCLC) require careful staging at the time of diagnosis to determine prognosis and guide treatment recommendations. The seventh edition of the TNM Classification of Malignant Tumors is scheduled to be published in 2009 and the International Association for the Study of Lung Cancer (IASLC) created the Lung Cancer Staging Project (LCSP) to guide revisions to the current lung cancer staging system. These recommendations will be submitted to the American Joint Committee on Cancer (AJCC) and to the Union Internationale Contre le Cancer (UICC) for consideration in the upcoming edition of the staging manual. Data from over 100,000 patients with lung cancer were submitted for analysis and several modifications were suggested for the T descriptors and the M descriptors although the current N descriptors remain unchanged. These recommendations will further define homogeneous patient subsets with similar survival rates. More importantly, these revisions will help guide clinicians in making optimal, stage-specific, treatment recommendations.