Deniz KÖKSAL, Seha AKDUMAN

Akciğer kanserinde 7. tnm evrelemesinden 8 . ye doğru

Ak ciğer k anserinin anatomik yay gın lığı, TNM sın ıflamasıyla tan ım lan ır ve h a len en önem li pro gnostik fa ktördür. Tümör öze llikle rin -lede ki de ğişiklikler, tan ısa l yöntem lerde ki ve te davide ki ge lişme lere b a ğlı o lara k TNM-evre leme sistemi zaman la günce llenme k te dir. 7. diTNM evre leme sistemi, u lus lararası, oldu kça geniş ve retrospe ktif b ir veri ta b an ına dayanara k o lu ş turu lmuş tur. Verilerin retrospek tifpeo lması ne deniyle h a len cevaplanmayan soru lar vardır. Bu ne den le Prospe ktif Akciğer Kanseri Evre leme Pro jesi o lu şturu lmu ştur. Bu urpro jede T, N, M tan ımlayıc ıların ın ayrıntılı de ğerlendirilmesinin yan ı sıra, şimdiye kadar hiç ele alınmayan demo grafik veriler, histo-hilo jik öze llikler, b az ı b iyo k imyasa l ve mo le kü ler pre dik tif ve pro gnostik b e lirleyiciler ince lenme kte dir. Pro je 8. TNM evre lem e sininesteme lini o lu şturaca ktır. Bu ma ka le de a k ciğer k anserin de 7. TNM evre lemesin den 8. ye do ğru mu h teme l de ğişiklikler tartışılm ış t rtır

From the $7^{th}$ tnm staging to the $8^{th}$ in lung cancer

T h e anatomic extent of disease, th at is describ e d b y th e TNM-c lassification remains th e most important pro gnostic factor for lun gl cancer. Based on the changes in tumor characteristics, advances in diagnostic methods and treatment strategies, TNM-classifica tionsat are u pdated from time to time. The$7^{th}$ TNM-classification was created on the basis of an international, large, and retrospe ctive ec data b ase. However due to retrospective data, th ere are still unanswere d questions. T h erefore "Prospective Lun g Cancer Sta gin gag Pro ject" is designed. In this pro ject, in addition to the detailed evaluation of T, N, M descriptors; other factors, which were no te considered to be relevant to lung cancer staging before, were also analyzed such as demographic data, histologic characteristics,is certain biochemical and molecular prognostic and predictive factors. This project will be the basis of 8 th TNM-classification for lun gl cancer. In th is manuscript, we discuss th e pro b a ble c h anges from th e$7^{th}$ T NM classific a tion to th e $8^{th}$.

PDF

___

1. Denoix PF. En q uete permanent dans les centres anticance - reux. Bu ll Inst Natl Hyg 1946;1:70-5 .
2. Mountain CF, Carr DT, An derson WA. A sy stem for th e clinica l staging of lung cancer. Am J Roentgeno l Ra dium T h er Nucl Me d 1974 ;120:130-8.
3. Go ldstraw P. Internationa l Association for th e Stu dy o f Lun g Cancer Sta gin g Manua l in T h oracic Onco lo gy. 1 st ed. t Florida , USA: Editoria l Rx Press; 2009 .
4. Go ldstraw P, Crowle y JJ. T h e Internationa l Association fo r th e Stu dy of Lun g Cancer internationa l sta ging pro ject on lun g cancer. J T h orac Oncol 2006;1:281-6 .
5. Go ldstraw P, Crowle y J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, et a l. T h e IASLC Lung Cancer Staging Project: proposa ls for th e revision of th e TNM sta ge groupin gs in the forth comin g (seventh ) e dition of th e TNM classification of ma lignant tumors. J T h orac Onco l 2007;2:706-14 .
6. Sh e pherd FA, Crowle y J, Van Houtte P, Postmus PE, Carney D, Ch ansky K, et a l. T h e IASLC Lun g Cance r Sta ging Pro ject: proposa ls re gardin g th e c linica l sta gin g o f sma ll-ce ll lung cancer in th e forth coming (seventh ) e dition of th e TNM c lassification for lun g cancer. J T h orac Onco l 2007;2:1067-77.
7. Travis WD, Giroux DJ, Ch ans ky K, Crowle y J, Asamura H, Bram b illa E, et a l. T h e IASLC Lun g Cancer Sta gin g Pro ject: Pro posa ls for th e inc lusion of Carcinoid tumours in th e forth coming (seventh ) e dition of th e TNM Classification fo r Lun g Cancer. J T h orac Onco l 2008;3:1213-23.
8. Mountain CF. Revisions in th e internationa l system for sta g- in g lun g cancer. Ch est 1997;111:1710-7.
9. Groome PA, Bo le jack V, Crowley JJ, Kenne dy C, Krasnik M, So b in LH, et a l. T h e IASLC Lun g Cancer Sta gin g Pro ject: Validation of the pro posals for revision of the T, N and M descriptors an d consequent stage groupings in th e forth- coming (seventh ) TNM classification for lun g cancer. J T h orac Onco l 2007;2:694-705.
10. Turna A. 7. evre lemeye do ğru: yanıtların ı a ldığımız soru la r ve h ava da ka lan ümitlerimiz. Türk Gö ğüs Ka lp Damar Ce r Derg 2008;16:71-3 .
11. Rami-Porta R, Ba ll D, Crowle y J, Giroux DJ, Jett J, Travis WD, et a l. T h e IASLC Lung Cancer Staging Project: propos - a ls for th e revision of th e T descriptors in th e forth comin g (seventh ) e dition of the TNM c lassification for lun g cancer. J T h orac Onco l 2007; 2:593-602 .
12. Rusch VW, Crowle y J, Giroux DJ, Go ldstraw P, Im JG, Tsu b oi M, et a l. T h e IASLC Lun g Cancer Sta gin g Pro ject: pro posa ls for th e revision of th e N descriptors in th e forth - coming seventh e dition of th e TNM classification for lun g cancer. J T h orac Onco l 2007; 27:603-12 .
13. Postmus PE, Bram b illa E, Ch ansky K, Crowle y J, Go ldstra w P, Patz EF Jr, et a l. T h e IASLC Lun g Cancer Sta gin g Pro ject: pro posa ls for revision of th e M descriptors in th e forth com - in g (seventh ) e dition of th e TNM classification of lun g cancer. J T h orac Onco l 2007; 2:686-93.
14. Rusch V, Asamura H, Watana b e H , Giroux DJ, Rami-Porta R, Go ldstraw P, et a l. T h e IASLC Lung Cancer Stagin g Pro ject: A Proposa l for a New Internationa l Node Map in th e Forth comin g Seventh Edition of th e TNM Classification for Lun g Cancer. J T h orac Onco l 2009;4:568-77.
15. Detterb ec k FC, Postmus PE, Tanoue LT. T h e sta ge c lassifi- cation of lung cancer. Diagnosis and management of lung cacer, 3 rd e d: ACCP evidence-b ase d clinica l practice guide lines. Ch est 2013;143(5)(Suppl):e191-e210 .
16. Giroux DJ, Rami-Porta R, Ch ansky K, Crowle y JJ, Groome PA, Postmus PE, et a l. T h e IASLC Lun g Cancer Sta gin g Pro ject. Data e lements for th e prospective Pro ject. J T h orac Onco l 2009 ;4:679-83.
17. Morgensztern D, Wa gar S, Su b ramanian J, Gao F, Trin k aus K, Govin dan R. Pro gnostic significance of tumor size in patients with sta ge III non-sma ll ce ll lun g cancer. A Surve lliance, Epidemio lo gy, an d En d Resu lts (SEER) surve y from 1998 to 2003. J T h orac Onco l 2012 ; 7:1479-84.
18. Travis WD, Bram b illa E, Rami-Porta R, Va llieres E, Tsu b o i M, Rusch V, et a l. Internationa l Sta gin g Committee. Viscera l pleural invasion: pathologic criteria and use of elastin stain: pro posa l for th e 7th e dition of TNM classification for lung cancer. J T h orac Onco l 2008 ; 3:1384-90.
19. Internationa l Pleura l Lavage Cyto logy Co lla b orators. Impac t of positive pleura l lava ge cyto lo gy on surviva l in patients u n dergoin g lun g resection for non-sma ll ce ll lun g cancer: an internationa l in dividua l patient data meta-an la ysis. J T h orac Cardiovasc Surg 2010;139:1441-6.
20. Toufe k tzian L, Sepsas E, Drossos V, Gk iozos I, Syrigos K. Pleura l lavage cyto logy: w h ere do we stan d? Lung Cance r 2 013 Oct 27. Doi: 10.1016/ j. lun gcan. 2013.10.012.
21. Wei S, Asamura H, Kawac h i R, Sa kurai H , Watana b e S. Which is the beter pro gnostic factor for resected non-small cell lun g cancer. The number of metastatic lymph nodes o r th e currently use d no da l sta ge c lassification? J T h orac Onco l 2011 ;6:310-8 .
22. Bergh mans T, Dusart M, Paesmans M, Hossein-Fouch er C, Buvat I, Castaigne C, et a l. Primary tumour standardize d u pta ke va lue (SUV max) measure d on floro deoxyglucose emission tomo graphy (PDG-PET) is of pro gnostic value fo r surviva l in non-sma ll ce ll lung cancer (NSCLC): A system - atic review an d meta-ana lysis (MA) b y th e European Lun g Cancer Work in g Party for th e IASLC Lun g Cancer Sta gin g Pro ject. J T h orac Onco l 2008;3:6-12 .