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Eighth Edition Staging of Thoracic Malignancies: Implications for the Reporting Pathologist
Andrew G Nicholson, Ming S Tsao, William D Travis
1From the Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (Dr Nicholson); the Department of Pathology, The Princess Margaret Cancer Centre, Toronto, Ontario, Canada (Dr Tsao); the Department of Pathology (Dr Travis) and the Thoracic Service, Department of Surgery (Dr Rusch), Memorial Sloan-Kettering Cancer Center, New York, New York; the Departments of Pathology (Dr Patil) and Thoracic and Cardiovascular Surgery (Dr Rice), Cleveland Clinic, Cleveland, Ohio; the Departement de Biopathologie, Cancer Center Leon Bernard, Lyon, France (Dr Galateau-Salle); the Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy (Dr Marino); the Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Dacic); the Department of Pathology, Mount Sinai Medical Center, New York, New York (Dr Beasley); the Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington (Dr Butnor); the Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan (Dr Yatabe); the Department of Thoracic Surgery, New York University, New York, New York (Dr Pass); the Department of Thoracic Surgery, Yale University, New Haven, Connecticut (Dr Detterbeck); the Department of Thoracic Surgery, Keio University, Tokyo, Japan (Dr Asamura); and the Thoracic Surgery Service, Hospital Universitari Mutua Terrassa, University of Barcelona, and CIBERES Lung Cancer Group, Terrassa, Barcelona, Spain (Dr Rami-Porta).
The 8th edition of the tumor, node, metastasis (TNM) staging system for thoracic malignancies has been updated. Pathologists should familiarize themselves with these changes for accurate reporting of lung, mesothelioma, thymic, and esophageal cancers.
Area of Science:
- Oncology
- Pathology
- Cancer Staging
Background:
- The International Association for the Study of Lung Cancer and collaborating groups developed proposals for the 8th edition TNM staging.
- These proposals address lung, mesothelioma, thymic epithelial, and esophageal cancers.
Purpose of the Study:
- To review the changes in the 8th edition TNM staging system.
- To discuss implications for reporting pathologists.
Main Methods:
- Analysis of international databases for lung, mesothelioma, thymic epithelial, and esophageal cancers.
- External validation using the US National Cancer Database.
Main Results:
- The 8th edition TNM staging proposals have been largely accepted by major cancer organizations.
- Implementation timelines vary, with the Union for International Cancer Control recommending January 2017 and the American Joint Committee on Cancer deferring to January 2018.
Conclusions:
- The 8th edition TNM staging incorporates significant changes relevant to pathologic staging of thoracic malignancies.
- Pathologists must become familiar with and adopt the 8th edition staging for accurate reporting.
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