Validation of the 9th edition of the TNM staging system for limited-stage small cell lung cancer after Resection: A multicenter study

IF 4.5 2区医学 Q1 ONCOLOGY Lung Cancer Pub Date : 2025-02-01 DOI:10.1016/j.lungcan.2025.108085

Leilei Wu , Jia-Yuan Tian , Ming-Jun Li , Feng Jiang , Li-Hong Qiu , Wan-Jun Yu , Xiao-Lu Chen , Rang-Rang Wang , Kun Li , Guo-Wei Ma , Jian Zeng , Dong Xie

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Abstract

Objectives

The 9th edition of the tumor-node-metastasis (TNM) staging system for lung cancer was proposed at the 2023 World Conference on Lung Cancer in Singapore. This study aimed to externally validate and compare the latest staging of small-cell lung cancer (SCLC).

Methods

Four hundred and eight patients with limited-stage SCLC were collected after lung resection from four centers. Survival curves by TNM stages were drawn using the Kaplan-Meier method and further compared by the Log-rank test. The Cox regression, receiver operating characteristics curves, area under the curve (AUC), Akaike information criterion (AIC), Bayesian information criterion (BIC), and Concordance index (C-index) were used in this study.

Results

In comparing IA vs. IIB, IIA vs. IIB, IIA vs. IIIA, IIA vs. IIIB, and IIIA vs. IIIB, the 9th edition had a better distinguishing ability than the eighth staging system (all p < 0.05). Besides, the 9th edition TNM staging had better predictive power and accuracy for the overall survival (OS) of SCLC patients over the 8th edition (AUC of 3-year OS: 0.680 vs. o.668; AIC: 4425.25 vs. 4444.52; BIC: 4493.44 vs. 4512.71; C-index: 0.637 [0.04] vs. 0.629 [0.039], p < 0.001).

Conclusions

Our external validation demonstrates that the ninth edition of pathological TNM staging for limited-stage SCLC is reasonable and valid based on a multicenter study. The ninth edition has better prognostic accuracy than the eighth edition.

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第9版TNM分期系统在有限期小细胞肺癌切除术后的验证：一项多中心研究。

目的：第9版肺癌肿瘤-淋巴结-转移（TNM）分期系统在2023年新加坡世界肺癌大会上被提出。本研究旨在外部验证和比较小细胞肺癌（SCLC）的最新分期。方法：从4个中心收集肺切除术后的有限期SCLC患者480例。采用Kaplan-Meier法绘制TNM分期生存曲线，并进一步采用Log-rank检验进行比较。本研究采用Cox回归、受试者工作特征曲线、曲线下面积（AUC）、赤池信息准则（AIC）、贝叶斯信息准则（BIC）和一致性指数（C-index）。结果：在比较IA与IIB、IIA与IIB、IIA与IIIA、IIA与IIIB、IIIA与IIIB时，第9版比第8版具有更好的区分能力（均p）。结论：我们的外部验证表明，基于多中心研究，第9版有限期SCLC病理TNM分期是合理有效的。第九版比第八版有更好的预测准确性。

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.