TNM and LUNG CANCER Proposed Changes to the

TNM and LUNG CANCER Proposed Changes to the 7 th Edition

TNM and LUNG CANCER LUNG ANATOMY

TNM and LUNG CANCER LUNG ANATOMY

TNM and LUNG CANCER

TNM and LUNG CANCER

TNM and LUNG CANCER

TNM and LUNG CANCER

TNM and LUNG CANCER

TNM and LUNG CANCER

TNM and LUNG CANCER

TNM and LUNG CANCER

TNM and LUNG CANCER

TNM and LUNG CANCER �First significant changes since 2009 �Based on data from 77, 000 lung cancer patients �Taxonomic refinement �Not intended to alter clinical practice

TNM and LUNG CANCER � 2015 WHO Classification �Captures a decade of remarkable advances in all specialties �Driven by rapid expansion of immunohistochemical and molecular tools �Reclassify tumors and improve subtyping

TNM and LUNG CANCER �Gives more weight to tumor size as a prognostic factor �Reclassifies some primary tumor descriptors �Validates current nodal descriptors �Modifies definition of some types of metastases

TNM and LUNG CANCER �EXPECTATIONS �Improve prediction of survival and recurrence �Survival benefit with platinum-based chemotherapy �Allow radiologic/pathologic correlations �Emphasizes solid tumor size vs whole tumor size

TNM and LUNG CANCER �Tumor 7 th edition � 1 -2 cm T 1 a �>2 but <3 cm T 1 b �>4 but <5 cm T 2 a �>5 but <7 cm T 2 b �>7 cm T 3 �Invade Diaphragm T 3 �<2 cm from carina T 3 8 th T 1 b T 1 c T 2 b T 3 T 4 T 2

TNM and LUNG CANCER �No Change in Nodal Descriptors �N 0 �N 1 �N 2 �N 3 No Nodal Metastasis Local Nodal Metastasis Regional Nodal Metastasis Distant Nodal Metastasis

TNM and LUNG CANCER �Metastases �Within Chest �Single/Single Organ �Multiple/ Single-Multiple 7 th Edition M 1 a M 1 b 8 th Edition M 1 a M 1 b M 1 c

TNM and LUNG CANCER �SUMMARY �Refinement of previous classification �Based on 77, 000 patients from 1999 to 2010 �Takes into consideration new advances in pathology �Gives more weight to tumor size �Hope to improve prediction of survival and recurrence �Expected to be enacted in January of 2017

TNM and LUNG CANCER