Akif TURNA, Ülkü YILMAZ, Güntülü AK, Berna Eren KÖMÜRCÜOĞLU, Sibel YURT

Küçük hücreli dışı akciğer kanserinde sekizinci evreleme ve uygulamadaki etkileri

Evreleme akciğer kanserli hastalara yaklaşımın önemli bir kısmını oluşturmaktadır. Tümör sınıflandırmasının esas amacı hastalığın anatomik yaygınlığını doğru olarak ortaya koymaktır. Tümörün anatomik yaygınlığı tedavi seçimi ve prognoz üzerinde önemli bir etkiye sahiptir. Küçük hücreli dışı akciğer kanserinde hastalara genel yaklaşım; mediastenin evrelenmesi ve toraks dışı evreleme için evreleme yöntemlerini, öykü ve fizik muayene, görüntüleme, minimal invaziv teknikler ve invaziv cerrahi teknikleri içermektedir. Mevcut akciğer kanseri evreleme sistemi tümör, lenf nodu ve metastaz (TNM) sınıflamasının Ocak 2017’de kullanılmaya başlanan sekizinci baskısıdır. Bu makalede, küçük hücreli dışı akciğer kanserinde evreleme yöntemleri ile birlikte mevcut TNM tanımlayıcıları ve evre grupları için tanımlar gözden geçirildi. Değişen T, N ve M tanımlayıcılarının hastalarda tedavi seçeneklerini daha iyi işaret edebildiği ve sağkalımı daha doğru bir şekilde öngörebildiği görülmektedir.

The eighth staging system of non-small cell lung cancer and its practical implications

Staging is an essential part of the approach to patients with lung cancer. The primary goal of the tumor classification is to correctly describe the anatomic extent of the disease. The anatomic extent of the tumor has a major impact on the treatment selection and prognosis. The general approach to patients with non-small cell lung cancer include mediastinal staging and non-thoracic staging methods, history and physical examination, imaging, minimally invasive techniques, and invasive surgical techniques. The current lung cancer staging system is the eighth edition of the tumor, node, and metastasis (TNM) classification, which was took effect in January 2017. In this article, staging methods and the definitions for current T, N, M descriptors and the stage groups in non-small cell lung cancer are reviewed. New definitions of T, N, and M factors seem to better indicate the most optimal treatment option for an individual patient and to better predict the survival in patients.

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1. Rami-Porta R, Bolejack V, Crowley J, Ball D, Kim J, Lyons G, et al. The IASLC Lung Cancer Staging Project: Proposals for the Revisions of the T Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer. J Thorac Oncol 2015;10:990-1003.