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Travis WD , Asamura H , Bankier AA , Beasley MB , Detterbeck F , Flieder DB , Goo JM , MacMahon H , Naidich D , Nicholson A , Powell CA , Prokop M , Rami-Porta R , Rusch V , van Schil P , Yatabe Y
The IASLC Lung Cancer Staging Project: Proposals for Coding T Categories for Subsolid Nodules and Assessment of Tumor Size in Part-Solid Tumors in the Forthcoming Eighth Edition of the TNM Classification of Lung Cancer
J Thorac Oncol. 2016 Aug;11(8) :1204-1223
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Abstract
This article proposes codes for the primary tumor categories of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA), and a uniform way to measure tumor size in part-solid tumors for the 8th edition of the tumor, node and metastasis (TNM) classification of lung cancer. In 2011 new entities of AIS, MIA and lepidic predominant adenocarcinoma (LPA) were defined and were later incorporated in the 2015 World Health Organization classification of lung cancer. To fit these entities into the T component of the staging system the Tis category is proposed for AIS, specifying Tis (AIS) if it is to be distinguished from squamous cell carcinoma in situ to be designated Tis (SCIS). We also propose MIA to be classified as T1mi. Furthermore, the use of the invasive size for T-descriptor size follows a recommendation made in three editions of the UICC TNM Supplement since 2003. For tumor size, the greatest dimension should be reported both clinically and pathologically. In nonmucinous lung adenocarcinomas, the computed tomography (CT) findings of ground glass versus solid opacities tend to correspond respectively to lepidic versus invasive patterns seen pathologically. However, this correlation is not absolute; so when CT features suggest nonmucinous AIS, MIA and LPA, the suspected diagnosis and clinical staging, should be regarded as a preliminary assessment that is subject to revision after pathologic evaluation of resected specimens. The ability to predict invasive versus non-invasive size based on solid versus ground glass components is not applicable to mucinous AIS, MIA or invasive mucinous adenocarcinomas because they generally show solid nodules or consolidation on CT.
Notes
1556-1380 Travis, William D Asamura, Hisao Bankier, Alexander A Beasley, Mary Beth Detterbeck, Frank Flieder, Douglas B Goo, Jin Mo MacMahon, Heber Naidich, David Nicholson, Andrew Powell, Charles A Prokop, Mathias Rami-Porta, Ramon Rusch, Valerie van Schil, Paul Yatabe, Yasushi International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee and Advisory Board Members Review Journal article J Thorac Oncol. 2016 Aug;11(8):1204-1223. doi: 10.1016/j.jtho.2016.03.025. Epub 2016 Apr 21.