Validation of the 7th TNM classification for non-small cell lung cancer: A retrospective analysis on prognostic implications for operated node-negative cases

Figures & data

Table I. Comparison between 6th and 7th TNM systems for N0 tumors (modified from Rami-Porta et al. [5].

T cm	6th TNM		7th TNM
≤ 2	T1	IA	T1a	IA
> 2–≤ 3			T1b	IA
> 3–≤ 5 (or ≤ 5 with invasion of pleura visceralis)	T2	IB	T2a	IB
> 5–≤ 7			T2b	IIA
> 7			T3	IIB

Table II. Patient characteristics.

	#	%
Age, median (range)	68 (39–86)
Age ≤ 70 y > 70 y	274 178	61 39
Gender Male Female	247 205	55 45
Histology Squamous-cell Adenocarcinoma Large-cell Adenosquamous Undifferentiated	147 240 14 36 15	33 53 3 8 3
Surgery Lobectomy Bilobectomy/pulmectomy	371 81	82 18
T cm, median (range)	3 (0.5–14)
Grade of differentiation G1 G1–2 G3 Missing	85 165 185 11	19 38 43
Tumor localization Left upper lobe Left lower lobe Right upper lobe Right middle lobe Right under lobe	136 55 150 17 94	30 12 33 4 21
Smoking history Current Former Never Unknown	238 125 36 52	53 28 8 11

Table III. Classification of 452 node-negative NSCLC patients according to the 6th and 7th TNM systems.

6th TNM				7th TNM
		# (%)				# (%)
T1	IA	230 (51)	→	T1a	IA	119 (26)
			→	T1b	IA	111 (25)
T2	IB	222 (49)	→	T2a	IB	142 (31)
			→	T2b	IIA	40 (9)
			→	T3	IIB	40 (9)

Figure 1. Kaplan-Meier curves of overall survival comparing the 6th TNM system (stage IA in A; stage IB in B) with the patient sub-grouping resulting from the 7th TNM classification.

Table IV. Univariate survival analysis.

	Overall Survival
	5-year survival rate %	Log-rank p-value
Age ≤ 70y > 70y	59 52	0.006
Gender Male Female	51 62	0.005
Histology Squamous Non-Squamous	50 59	0.234
Surgery Lobectomy Bilobectomy/Pulmectomy	59 47	0.214
Grade of Differentiation G1 G1–2 G3	63 57 52	0.079
Tumor Localization Left upper lobe Left lower lobe Right upper lobe Right middle lobe Right under lobe	56 43 61 55 53	0.228
Smoking history Current Former Never Unknown	57 53 76 43	0.073
Stage, 6^th TNM IA IB	62 51	0.036
Stage, 7^th TNM IA–T1a IA–T1b IB IIA IIB	70 51 54 51 35	0.002

Rami-Porta R, Ball D, Crowley J, Giroux DJ, Jett J, Travis WD, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol 2007;2:593–602.

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