The International Association for the Study of Lung Cancer Mesothelioma Staging Project: Proposals for the M Descriptors in the Forthcoming Ninth Edition of the TNM Classification for Pleural Mesothelioma

IF 21 1区 医学 Q1 ONCOLOGY Journal of Thoracic Oncology Pub Date : 2024-11-01 DOI:10.1016/j.jtho.2024.08.022
Hedy L. Kindler MD , Adam Rosenthal MS , Dorothy J. Giroux MS , Anna K. Nowak M.B.B.S., PhD , Andrea Billè MD, PhD , Ritu R. Gill M.B.B.S., MPH , Harvey Pass MD , David Rice MD , Robert T. Ripley MD , Andrea Wolf MD, MPH , Kevin G. Blyth MD , Susanna Cedres MD, PhD , Valerie Rusch MD , Members of the IASLC Staging and Prognostic Factors Committee, Advisory Boards and Participating Institutions
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Abstract

Introduction

The International Association for the Study of Lung Cancer developed a global multicenter database to propose evidence-based revisions for the ninth edition of the TNM classification of pleural mesothelioma (PM). This study analyzes the M category to validate eighth edition M category recommendations.

Methods

Cases were submitted electronically or by transfer of existing institutional databases for patients with histologically or cytologically confirmed PM. The presence and number of metastases (single versus multiple) in each of eight organ systems were reported for patients with M1 disease at diagnosis. Overall survival (OS) was calculated by the Kaplan-Meier method. Differences in OS were assessed by log-rank test.

Results

Of 7338 submitted cases, 3598 were eligible and 3221 had sufficient data for clinical staging; 228 cases (7%) were M1. Median overall estimated survival was inferior for M1 compared with M0 patients: 10.5 months versus 21.5 months, respectively (p < 0.0001); estimated 1-year survival was 46% versus 71%, respectively. OS differences between M categories were preserved within histologic subgroups. Among 158 patients with organ-specific documentation of M1 disease, there was no statistically significant difference in OS between those with intrathoracic versus more distant metastatic disease (14.4 mo versus 10.9 mo, p = 0.64). No significant survival difference was detected between patients with metastatic disease in a single-organ system versus multiple-organ systems (12.6 mo versus 8.8 mo, p = 0.45).

Conclusions

This evidence-based analysis of the M category for PM conforms with the eighth edition M descriptors. No changes are proposed in the ninth edition of the mesothelioma M category.
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IASLC 间皮瘤分期项目:关于即将出版的胸膜间皮瘤 TNM 分类第 9 版中 M 级描述符的建议。
导言:国际肺癌研究协会(IASLC)开发了一个全球多中心数据库,为第9版胸膜间皮瘤(PM)的肿瘤结节转移(TNM)分类提出循证修订建议。本研究分析了M分类,以验证第8版M分类的建议:方法:病例以电子方式提交,或从现有的机构数据库中调取经组织学或细胞学确诊的胸膜间皮瘤患者的资料。对于诊断时为M1疾病的患者,报告八个器官系统中每个系统是否存在转移灶以及转移灶的数量(单个或多个)。总生存期(OS)采用 Kaplan-Meier 法计算。OS 的差异通过对数秩检验进行评估:在提交的 7,338 个病例中,3,598 个符合条件,3,221 个有足够数据进行临床分期;228 个病例(7%)为 M1。与 M0 患者相比,M1 患者的中位总估计生存率较低:分别为 10.5 个月和 21.5 个月(p 结论:这是一项基于证据的 M 级分类分析:对 PM 的 M 级分类进行的循证分析符合第 8 版的 M 级描述。第9版的间皮瘤M分类没有提出任何变化。
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来源期刊
Journal of Thoracic Oncology
Journal of Thoracic Oncology 医学-呼吸系统
CiteScore
36.00
自引率
3.90%
发文量
1406
审稿时长
13 days
期刊介绍: Journal of Thoracic Oncology (JTO), the official journal of the International Association for the Study of Lung Cancer,is the primary educational and informational publication for topics relevant to the prevention, detection, diagnosis, and treatment of all thoracic malignancies.The readship includes epidemiologists, medical oncologists, radiation oncologists, thoracic surgeons, pulmonologists, radiologists, pathologists, nuclear medicine physicians, and research scientists with a special interest in thoracic oncology.
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