The International Association for the Study of Lung Cancer Mesothelioma Staging Project : Proposals for Revisions of the "T" Descriptors in the Forthcoming Ninth Edition of the TNM Classification for Pleural Mesothelioma

Copyright © 2024 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved..

INTRODUCTION: The primary tumor (T) component in the eighth edition of pleural mesothelioma (PM) staging system is based on pleural involvement and extent of invasion. Quantitative assessment of pleural tumor has been found to be prognostic. We explored quantitative and qualitative metrics to develop recommendations for T descriptors in the upcoming ninth edition of the PM staging system.

METHODS: The International Association for the Study of Lung Cancer prospectively collected data on patients with PM. Sum of maximum pleural thickness (Psum) was recorded. Optimal combinations of Psum and eighth edition cT descriptors were assessed using recursive binary splitting algorithm, with bootstrap resampling to correct for the adaptive nature of the splitting algorithm, and validated in the eighth edition data. Overall survival (OS) was calculated by the Kaplan-Meier method and differences in OS assessed by the log-rank test.

RESULTS: Of 7338 patients submitted, 3598 were eligible for cT analysis and 1790 had Psum measurements. Recursive partitioning identified optimal cutpoints of Psum at 12 and 30 mm, which, in combination with extent of invasion, yielded four prognostic groups for OS. Fmax greater than 5 mm indicated poor prognosis. cT4 category (based on invasion) revealed similar performance to eighth edition. Three eighth edition descriptors were eliminated based on low predictive accuracy. Eighth edition pT descriptors remained valid in ninth edition analyses.

CONCLUSION: Given reproducible prognostication by Psum, size criteria will be incorporated into cT1 to T3 categories in the ninth edition. Current cT4 category and all pT descriptors will be maintained, with reclassification of fissural invasion as pT2.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer - (2024) vom: 21. März

Sprache:

Englisch

Beteiligte Personen:

Gill, Ritu R [VerfasserIn]
Nowak, Anna K [VerfasserIn]
Giroux, Dorothy J [VerfasserIn]
Eisele, Megan [VerfasserIn]
Rosenthal, Adam [VerfasserIn]
Kindler, Hedy [VerfasserIn]
Wolf, Andrea [VerfasserIn]
Ripley, Robert T [VerfasserIn]
Billé, Andre [VerfasserIn]
Rice, David [VerfasserIn]
Opitz, Isabelle [VerfasserIn]
Rimner, Andreas [VerfasserIn]
de Perrot, Marc [VerfasserIn]
Pass, Harvey I [VerfasserIn]
Rusch, Valerie W [VerfasserIn]
members of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Boards and Participating Institution [VerfasserIn]

Links:

Volltext

Themen:

Clinical stage
Journal Article
Pleural mesothelioma
Staging
T component

Anmerkungen:

Date Revised 25.04.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1016/j.jtho.2024.03.007

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370107799