Validation of the UICC eighth edition of the TNM classification for lung cancer / 中国肿瘤临床

ABSTRACT

Objective: To evaluate the 8th edition of the TNM classification in an independent cohort of Chinese lung cancer patients. Methods: Using the UICC 7th and 8th editions of the TNM classification, we retrospectively analyzed 3,825 Chinese patients who were diagnosed with stage to non-small cell lung cancer (NSCLC) and received surgical treatment. A survival analysis of each subgroup was carried out using the Kaplan-Meier method. The Cox regression analysis was used to evaluate the differences between subgroups. Results: In total, 906 (23.7%) patients were redefined as having a new pStage and shifted to a higher pStage group in the 8th edition. On the basis of the 8th edition of the TNM classification, the differences between every two adjacent stage groups were found to be significant, except between A1 and A2 (P=0.057). Significant differences were observed between every two adjacent groups stratified by the T and N descriptors. Besides, significant differences were observed between M0 and M1a (P<0.001), whereas no significant difference was observed between M1a and M1b (P=0.397). Conclusions: Compared with the 7th edition of the TNM classification, the 8th edition provides more accurate prognostic information, particularly among NSCLC patients at pathologic stages A1, A2, and A3.